Al-Ibraheem Akram, Brink Anita, Lee Sze Ting, De Los Reyes Amelia, Paez Diana, Craviolatti Pietro Selemo, Olier Augusto Llamas, Giammarile Francesco, Abdlkadir Ahmed S, Estrada-Lobato Enrique, Abdel-Wahab May, Prior John, Scott Andrew M, Sathekge Mike Machaba
Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan; School of Medicine, University of Jordan, Amman, Jordan.
Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
Semin Nucl Med. 2025 Aug 30. doi: 10.1053/j.semnuclmed.2025.07.005.
Radiotheranostics represent a cutting-edge advancement in the management of noncommunicable diseases, integrating diagnostic imaging with targeted radiotherapy in a single, personalized approach. Over the past decade, the field has gained substantial momentum, with several radiopharmaceuticals now incorporated into clinical practice, most notably for neuroendocrine tumors and prostate cancer. The pipeline of novel agents continues to grow, offering promising therapeutic options for patients with cancers resistant to conventional therapies. Despite these advances, the broad implementation of radiotheranostics is impeded by several challenges, including logistical constraints, financial limitations, resource scarcity, political instability, and regulatory and educational barriers. Overcoming these obstacles requires coordinated mitigation strategies focused on strengthening education and training, expanding radiopharmaceutical production and development, enhancing research capacity, and establishing robust quality management systems. This review provides a comprehensive overview of the current global landscape of radiotheranostics, identifies key implementation barriers, and offers expert-driven strategies and recommendations from the International Atomic Energy Agency to support sustainable and equitable access to radiotheranostics.
放射治疗诊断学代表了非传染性疾病管理方面的一项前沿进展，它以单一的个性化方法将诊断成像与靶向放射治疗相结合。在过去十年中，该领域取得了长足发展，目前已有多种放射性药物应用于临床实践，最显著的是用于神经内分泌肿瘤和前列腺癌。新型药物的研发仍在不断推进，为对传统疗法耐药的癌症患者提供了有前景的治疗选择。尽管取得了这些进展，但放射治疗诊断学的广泛应用仍受到诸多挑战的阻碍，包括后勤限制、资金不足、资源短缺、政治不稳定以及监管和教育障碍等。克服这些障碍需要协调一致的缓解策略，重点是加强教育和培训、扩大放射性药物的生产和研发、提高研究能力以及建立健全的质量管理体系。本综述全面概述了当前放射治疗诊断学的全球现状，确定了关键的实施障碍，并提供了国际原子能机构专家主导的策略和建议，以支持可持续和公平地获取放射治疗诊断学服务。
