Nuclear Medicine

Nuclear medicine is a clinical speciality that employs radiopharmaceuticals to visualise, quantify and treat disease at the molecular and cellular level. Unlike structural modalities such as CT or MRI, nuclear imaging captures physiological processes by detecting radiation emitted from within the patient after administration of a radiotracer. Radiopharmaceuticals—radioactive isotopes bound to biologically active molecules—may localise to specific organs or disease sites by mechanisms including metabolic trapping, receptor binding and ion exchange. Planar imaging and tomographic techniques (SPECT and PET) provide semi-quantitative measures of tracer uptake, informing diagnosis, staging and assessment of therapeutic response. Beyond diagnostics, targeted radionuclide therapy delivers cytotoxic radiation (beta or alpha emitters) to malignant or hyperfunctional tissues, exemplified by iodine-131 in thyroid disease and emerging peptide-based alpha therapies for micrometastatic cancer. Advances in instrumentation, hybrid imaging (PET/CT, SPECT/CT, PET/MRI) and radiochemistry continue to broaden the impact of nuclear medicine in personalised patient management.

Research from Nature Portfolio

Innovations in generator technology have enhanced access to gallium-68 for PET imaging. A novel 68Ge/68Ga generator based on nano-tin dioxide demonstrated robust performance over extended elution cycles. The system consistently delivered high-purity 68Ga suitable for labelling of DOTA-conjugated peptides, maintaining elution yields above 90 % during prolonged use. This advance supports routine on-demand tracer production without reliance on nearby cyclotrons, expanding theranostic applications in neuroendocrine and prostate cancer imaging.

Fundamental studies on actinium coordination have guided the design of chelators for targeted alpha therapy. By embedding an eight-coordinate synthetic ligand within a mammalian protein scaffold, researchers characterised both solution-phase and crystalline structures of actinium-227 complexes. These insights into binding geometry and stability under physiological conditions inform the rational development of chelators for actinium-225 radiopharmaceuticals, aiming to improve in vivo retention and reduce off-target toxicity in alpha-emitter therapies.

Research from all publishers

A comprehensive review of radiotheranostics has outlined the seamless integration of PET tracers into therapeutic paradigms. Early clinical experiences with PSMA-directed radioligands in prostate cancer illustrate how the same molecular target can guide both diagnostic PET imaging and beta- or alpha-emitter therapy. Evidence indicates that high PSMA expression on PET predicts favourable responses to targeted radionuclide therapy, reinforcing the paradigm of “see-and-treat” in precision oncology.

Parallel work in molecular imaging for targeted anticancer agents has highlighted the role of PET in evaluating drug delivery and early treatment response. Multimodal PET studies using tracers for amino acid transport, hypoxia and receptor occupancy enable quantification of pharmacodynamics in vivo. Emerging artificial-intelligence algorithms applied to multiparametric PET data improve sensitivity and specificity in detecting resistant tumour clones, guiding adaptive therapeutic strategies and accelerating clinical translation of novel drugs.

Nuclear Medicine publication trend

The graph below shows the total number of articles in nuclear medicine across all publications each year (not limited to Nature Index journals).

Technical terms

Radiopharmaceutical: A radioactive compound comprising a radionuclide linked to a biologically active molecule for imaging or therapy.

SPECT (Single-Photon Emission Computed Tomography): A tomographic nuclear imaging method that acquires gamma-ray emission data from multiple angles to reconstruct 3D tracer distribution.

PET (Positron Emission Tomography): A functional imaging technique that detects coincident gamma photons from positron annihilation, enabling high-sensitivity quantification of tracer uptake.

Generator: A system that produces a short-lived radionuclide (e.g. 68Ga) from a longer-lived parent isotope (e.g. 68Ge) on demand without an on-site cyclotron.

Theranostics: An approach combining diagnostic imaging and targeted radionuclide therapy using the same or similar molecular vector to personalise treatment.

References

1. Development and long-term evaluation of a new 68Ge/68Ga generator based on nano-SnO2 for PET imaging. Scientific Reports (2020).
2. Actinium chelation and crystallization in a macromolecular scaffold. Nature Communications (2024).
3. Radiotheranostics in oncology: Making precision medicine possible. CA A Cancer Journal for Clinicians (2023).
4. Current use of PSMA–PET in prostate cancer management. Nature Reviews Urology (2016).
5. Molecular and functional imaging in cancer-targeted therapy: current applications and future directions. Signal Transduction and Targeted Therapy (2023).