Abstract
Theranostic radiopharmaceuticals represent an approach that combines diagnosis and therapy through the same molecular target, and preclinical molecular imaging plays a critical role in validating this dual structure. This review addresses the function of imaging in the preclinical evaluation of theranostic radionuclide pairs within the scope of major theranostic radionuclide pairs, surrogate imaging strategies, imaging-based dosimetry prediction, and theranostic pair consistency. The challenges of microdosimetric heterogeneity and daughter radionuclide redistribution specific to alpha-emitting agents are discussed, and concrete translational examples are presented through prostate-specific membrane antigen, dodecane tetraacetic acid tyr3-octreotate, and nanobody-based agents. The main theme of the review is how imaging data functions as a bridge between the diagnostic and therapeutic phases, and how it guides the optimization of theranostic agents and dosimetry prediction.
Keywords:
Theranostics, preclinical imaging, pair of radionuclide, surrogate imaging, dosimetry
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