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In the early 1900s, English chemist Frederick Soddy realized that an element could have atoms with different masses that were chemically indistinguishable. These different types are called isotopes — atoms of the same element that differ in mass. Isotopes differ in mass because they have different numbers of neutrons but are chemically identical because they have the same number of protons. Soddy was awarded the Nobel Prize in Chemistry in 1921 for this discovery.
An isotope containing...
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Radiotheranostics in Low- and Middle-Income Countries: Challenges, Practice, and Prospects.

Ismaheel O Lawal1,2, Honest Ndlovu2,3, Joseph Kabunda2,3

  • 1Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, United States.

World Journal of Nuclear Medicine
|November 12, 2025
PubMed
Summary

Radiotheranostics offers advanced cancer diagnosis and treatment, especially for low- and middle-income countries (LMICs). Despite challenges in access and infrastructure, its potential for improving cancer care in LMICs is significant.

Keywords:
177 Lu-PSMA225 Ac-PSMAlow- and middle-income countriesnuclear medicineprostate cancerradiotheranostics

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiotheranostics

Background:

  • Global cancer incidence and mortality are rising, with low- and middle-income countries (LMICs) disproportionately affected.
  • Effective strategies for cancer prevention, early diagnosis, treatment, and survivorship are crucial for LMICs.
  • Radiotheranostics, combining diagnostic imaging and targeted therapy with radiopharmaceuticals, shows promise for enhanced cancer management.

Purpose of the Study:

  • To explore the potential of radiotheranostics in addressing the growing cancer burden in LMICs.
  • To identify barriers hindering the adoption of nuclear medicine and radiotheranostics in LMICs.
  • To highlight successful applications and ongoing improvements in radiotheranostics services within LMICs.

Main Methods:

  • Review of current literature on radiotheranostics applications in oncology.
  • Analysis of challenges faced by LMICs in implementing nuclear medicine services.
  • Case examples of successful radiotheranostics implementation in LMICs, particularly for prostate cancer.

Main Results:

  • Radiotheranostics provides sensitive functional imaging for early detection and treatment response assessment.
  • Key barriers in LMICs include workforce shortages, inadequate infrastructure, limited funding, and regulatory hurdles.
  • Successful clinical applications, such as PSMA-targeted radiotheranostics for prostate cancer, have emerged from LMICs, notably South Africa, India, and Türkiye.

Conclusions:

  • Radiotheranostics holds significant potential to improve cancer diagnosis, treatment, and surveillance in LMICs.
  • Addressing infrastructural, educational, and financial barriers is essential for expanding radiotheranostics access.
  • Collaborative efforts involving international organizations, governments, and the private sector are driving progress in LMICs' nuclear medicine capabilities.