Search Results (537)

5-Aminolevulinic acid (5-ALA) has emerged as an important theranostic agent in oncology due to its selective intracellular conversion to protoporphyrin IX (PpIX), enabling both photodynamic diagnosis (PDD) and photodynamic therapy (PDT). This narrative review summarizes current knowledge regarding the biological mechanisms underlying 5-ALA metabolism, selective tumor accumulation, and the clinical applications of 5-ALA-based approaches across multiple oncological indications. Particular emphasis is placed on glioblastoma, head and neck lesions, dermatological malignancies, urological cancers, gynecological lesions, and emerging translational applications. The review also discusses key biological and technical limitations, including tumor hypoxia, restricted light penetration, heterogeneous PpIX accumulation, resistance mechanisms, and tumor-specific variability. Recent advances in drug delivery systems, nanotechnology, sonodynamic therapy, radiodynamic strategies, and combination immunotherapeutic approaches are also highlighted. Collectively, current evidence indicates that while 5-ALA has established clinical utility in selected indications, many applications remain preclinical or early translational, underscoring the need for further well-designed clinical studies. Full article

Nanotheranostics integrate theranostic functions onto a single nanoscale platform, and have become a new approach in precision medicine. Nanotheranostics rely on probes. However, traditional fluorescent probes often exhibit aggregation-caused quenching (ACQ) when loaded at high concentrations onto nanocarriers, severely limiting their imaging performance. Aggregation-induced emission agents (AIEgens) offer a solution to this long-standing problem through their ability to enhance fluorescence during aggregation. This mini-review systematically outlines nanotheranostic systems based on aggregation-induced emission (AIE). We first introduce the basic mechanism of AIE (the limitation of molecular internal motion) and its advantages over traditional fluorescent probes. Then, we discuss the design strategies of AIE nanoprobes according to the types of nanocarriers (including liposomes, polymer nanoparticles, and self-assembling systems). Additionally, we emphasize the disease-specific AIE nanotheranostic designs tailored for pathological microenvironments such as tumors, neurodegenerative diseases, and inflammatory diseases. Finally, we conduct an in-depth analysis of the current challenges hindering clinical translation, and propose future AIE nanotheranostic technologies applicable to clinical practice and the direction for personalized medicine. Full article

Achieving precise control over anticancer drug release remains one of the key challenges in modern pharmaceutical development, as it directly determines therapeutic efficacy, systemic toxicity, and patient outcomes. This review critically evaluates recent advances in three major formulation strategies: polymeric solid dispersions, cyclodextrin-based inclusion complexes, and metal–organic frameworks (MOFs), with a particular focus on their capacity to tailor anticancer drug release. Over the past decade, polymeric solid dispersions and cyclodextrin-based carriers have played a central role in improving the dissolution and bioavailability of poorly water-soluble anticancer agents, while also enabling modified release profiles through rational formulation design. Increasing structural complexity, including ternary systems and supramolecular assemblies, reflects a shift toward more controllable delivery platforms. In recent years, MOFs have emerged as highly adaptable porous materials capable of supporting controlled and stimuli-responsive release. The integration of imaging agents, magnetic components, and photothermal functionalities has further enabled the design of multifunctional and theranostic platforms. Taken together, these technologies reflect a shift from conventional solubility enhancement toward structurally engineered systems designed to achieve predictable and controlled drug release. Continued advances in material design and formulation strategies are expected to further refine release kinetics and support the development of next-generation anticancer therapies aligned with the growing demand for precision medicine. Full article

Copper-64 is increasingly recognized for its advantages in positron emission tomography (PET) imaging and theranostic applications due to its favorable half-life, decay profile, and high spatial resolution. This research addresses the need for reliable, high-purity PET radiotracers by developing GMP-grade lyophilized kits for one-step preparation of ⁶⁴Cu-NOTA-peptides using gelatin as a chelating agent for metallic impurities and NOTA for selective copper binding. The approach was applied to five peptide analogs formulated for fast ⁶⁴Cu labeling: NOTA-iPSMA, NOTA-TOC, NOTA-iPD-L1, NOTA-iFAP, and NOTA-UBI 29–41, which were preclinically evaluated to enable the precise molecular imaging of cancer and infection. Each multidose kit included 0.5 μmol of the NOTA-peptide and 25 mg of gelatin, labeled with 925 MBq of ⁶⁴Cu. The radiochemical purity of the ⁶⁴Cu-NOTA-peptides exceeded 98% (mean 99.2% ± 0.3%) without the need for additional purification. The ⁶⁴Cu-radiotracers remained stable for at least 24 h at room temperature and showed high stability in human serum. In preclinical studies, saturation-binding assays demonstrated that affinity (Kd) was less than 10 nM in all ⁶⁴Cu-NOTA-peptides, with tumor-to-lung ratios ranging from 14 to 290 at 2 h post-injection and low liver uptake (2.95% ± 1.36% ID/g). The research demonstrated that these formulations, which include peptides specific to PSMA, SSTR2, PD-L1, FAP, and infection sites, offer excellent in vivo performance and high PET imaging quality in mice with induced tumors or infection sites. The findings support the use of gelatin-NOTA-peptide kits as a standardized and practical solution for producing ⁶⁴Cu-labeled peptides, facilitating routine clinical PET imaging, and advancing personalized molecular diagnostics. Full article

Background/Objectives: Small-cell prostate cancer (SCPC) is a rare, aggressive variant of prostate cancer with poor prognosis, arising “de novo” or through lineage plasticity from conventional adenocarcinoma under androgen receptor-targeted therapies. Characterized by low PSA levels despite high tumor burden and visceral metastases, SCPC poses diagnostic challenges with conventional and PSMA-targeted imaging due to variable tracer uptake. This narrative review aims to evaluate the role of PET/CT tracers in clinical and preclinical settings for SCPC diagnosis, staging, and management. Methods: A systematic literature search was conducted on PubMed and Scopus up to December 2025 using terms “PET OR positron emission tomography AND prostate OR prostatic AND small-cell NOT non-small-cell”. Eight studies (five clinical, three preclinical) on the role of PET/CT imaging in SCPC were included and analyzed for study design, population, tracers, and findings, with comparative evaluation of diagnostic performance across PET tracers. Results: Clinical studies showed that ¹¹C-choline detects progression at low PSA but misses SCPC; ¹⁸F-FDG exhibited a high SUVmax value for distinguishing SCPC from adenocarcinomas with neuroendocrine differentiation, predicting poor survival; ⁶⁸Ga-DOTATATE identified NEPC/SCPC with promising prognostic/therapeutic value for selected cases. Preclinical models evaluated ⁸⁹Zr-tracers targeting DLL3 or CDCP1 (an antigen expressed in aggressive neuroendocrine tumours) and ¹⁸F-BnTP (a target of mitochondrial activity) in SCPC subtypes, focusing on translational imaging. Conclusions: From this review, although still based on limited literature evidence and mostly derived from retrospective and small SCPC sub-cohorts,¹⁸F-FDG PET/CT currently appears as the most reliable tracer for SCPC, aiding tumor detection and prognostication when PSMA/choline imaging fails. In the preclinical setting, DLL3/CDCP1-targeted agents emerge as promising theranostics tools. Multimodal imaging approach and prospective trials are needed for standardization and patient-based SCPC management. Full article

Metal–organic frameworks (MOFs) possess unique structural tunability, abundant coordination sites, and outstanding biosafety, rendering them highly advantageous for the development of high-performance magnetic resonance imaging (MRI) contrast agents. In light of the significant advancements in MOF-derived theranostic platforms, a comprehensive overview focusing on their classification and clinically oriented applications is urgently required. This review provides an in-depth examination of various categories of MOF-derived contrast agents, including T1, T2, dual-mode, ratiometric and 19F imaging systems, and analyzes the correlation between structural characteristics and imaging performance. Furthermore, it highlights typical MRI-guided therapeutic applications, such as those related to atherosclerosis, bacterial infections, and cancer immunotherapy. The review systematically addresses existing challenges, including issues related to biodegradability, metabolic behavior, and biosafety. It also summarizes the rational design principles for novel MOF contrast agents, aiming to facilitate their transition from fundamental research to clinical applications. Full article

Cell-based immunotherapies require noninvasive tools that can quantify the migration, biodistribution, and persistence of administered immune cells. This review focuses primarily on oncologic immune cell therapy, while also considering selected inflammatory disease models in which immune-cell trafficking is biologically relevant. We critically compare direct radionuclide labeling, sodium iodide symporter (NIS)-based reporter gene imaging, radionuclide-integrated nanoplatforms, and Cerenkov-based hybrid optical conversion strategies. Direct labeling with agents such as [⁸⁹Zr]Zr-oxine, [¹¹¹In]In-oxine, and [⁹⁹ᵐTc]Tc-HMPAO enables early positron emission tomography (PET)/single-photon emission computed tomography (SPECT) biodistribution assessment, usually within hours to several days after cell administration. NIS reporter imaging with [¹²⁴I]NaI, [¹²³I]NaI, [⁹⁹ᵐTc]TcO₄⁻, or [¹⁸F]TFB supports repeated viability-dependent imaging, because signal generation depends on active transporter expression in living engineered cells. Radionuclide-integrated gold nanoplatforms can improve intracellular retention and offer theranostic potential through combined imaging, photothermal, radiotherapeutic, or immunomodulatory functions. We further discuss PET/SPECT balance, radiopharmaceutical nomenclature, nanoparticle stabilization, ethical aspects of genetic modification, tumor-on-a-chip systems for preclinical testing, and limitations of narrative evidence synthesis. Together, these platforms provide complementary strategies for image-guided immune cell therapy, with translational relevance for patient selection, treatment optimization, safety monitoring, and oncology practice. In conclusion, NIS-centered nuclear imaging and radionuclide-integrated nanoplatforms represent complementary, clinically actionable tools for quantitative immune-cell tracking, therapeutic optimization, and safety monitoring in translational oncology and inflammatory disease research. Full article

The creation of innovative systems that are able to combine diagnosis and therapy is a crucial opportunity in nuclear medicine. Here, we propose a methodological and multiscale approach for the development of a theranostic platform based on AuNRs functionalized with radiopharmaceuticals. AuNRs offer a versatile and effective system due to their unique physicochemical properties and the possibility of surface functionalization with targeting molecules. Within this framework, key challenges include the functionalization of AuNRs to target the cell nucleus, the loading of AuNRs with radiopharmaceuticals, and the investigation of Auger electron emission from AuNRs under gamma irradiation. Multiscale modelling is employed to describe the behaviour of the system within the cellular environment and to predict potential radiobiological enhancement effects, including synergistic interactions between functionalized AuNRs and radiopharmaceutical agents such as ^99mTc-sestaMIBI. The experimental activity includes gamma irradiation studies, along with the structural and physical characterization of nanomaterials and in vitro biological investigations on T98G cells, to evaluate cytotoxicity and metabolic alterations, with the aim of assessing the potential synergistic effects of the combined system. Full article

Background/Objectives: Boron neutron capture therapy (BNCT) relies on the selective delivery of boron-10 to tumor cells. Although 4-[¹⁰B]borono-L-phenylalanine (BPA) is currently the only clinically approved BNCT agent, it is limited by poor L-type amino acid transporter 1 (LAT1)/LAT2 selectivity and aqueous solubility. We previously developed 3-borono-5-fluoro-α-methyl-L-phenylalanine (5F-αMe-3BPA), a novel BPA derivative designed to be a LAT1-targeted BNCT/positron emission tomography theranostic agent. This study comprehensively characterizes its pharmacological profile and explores its pharmacokinetic optimization by modulating renal organic anion transporter 1 (OAT1). Methods: Transport kinetics of BPA, related analogs, and 5F-αMe-3BPA were analyzed in HEK293 cells stably expressing LAT1 or LAT2 using Michaelis–Menten analysis. Time-dependent cellular uptake and intracellular retention of BPA and 5F-αMe-3BPA were evaluated in T3M-4 pancreatic cancer cells with or without the LAT1 inhibitor JPH203. In vivo biodistribution was examined in T3M-4 tumor-bearing mice after intravenous administration of 5F-αMe-3BPA or BPA, with assessment of probenecid pretreatment. Results: 5F-αMe-3BPA retained LAT1 affinity comparable to that of BPA while showing markedly reduced LAT2-mediated transport, indicating improved LAT1/LAT2 selectivity. In T3M-4 cells, 5F-αMe-3BPA showed stronger LAT1 dependence, higher steady-state accumulation, and better intracellular retention than BPA under amino acid-containing conditions. Although 5F-αMe-3BPA achieved favorable tumor-to-plasma and tumor-to-muscle ratios in vivo, it was rapidly cleared from circulation. Probenecid pretreatment increased plasma exposure, reduced early renal accumulation, and significantly enhanced tumor boron accumulation, reaching approximately twofold higher levels than control. Conclusions: These findings establish 5F-αMe-3BPA as a highly LAT1-selective BNCT candidate and identify probenecid pretreatment as a clinically translatable pharmacokinetic strategy for maximizing therapeutic boron delivery. Full article

Magnetic resonance techniques have evolved beyond conventional proton-based imaging, enabling access to a broader range of nuclei that provide complementary structural, functional, and molecular information. This review presents a comprehensive overview of multinuclear NMR and MRI in solid and soft materials as well as in biomedical applications, with particular emphasis on ¹H, ¹³C, ³¹P, ²³Na, and ¹⁹F nuclei. Proton-based methods remain the foundation of magnetic resonance due to their high sensitivity and widespread applicability, offering insights into molecular mobility, hydration, and microstructural heterogeneity. In contrast, heteronuclear approaches enable more specific characterization of chemical structure (¹³C), phosphorus-containing functional groups and membranes (³¹P), ionic homeostasis and transport (²³Na), and exogenous tracers with negligible biological background (¹⁹F). Together, these techniques extend magnetic resonance from primarily anatomical imaging toward functional, metabolic, and molecular-level analysis. The review further discusses key hardware aspects, including magnetic field strength and radiofrequency coil design, highlighting the trade-offs between low- and high-field systems and the growing importance of multinuclear coil architectures. For example, because ¹H, ²³Na, ³¹P, and ¹⁹F resonate at different Larmor frequencies, multinuclear experiments require dedicated or multi-tuned RF coils that balance sensitivity, field homogeneity, and decoupling between channels. Mechanisms of contrast generation are examined in detail, distinguishing between endogenous sources—such as water, ions, and metabolites—and exogenous contrast agents, including gadolinium-, manganese-, and fluorine-based compounds, as well as targeted and theranostic platforms. A comparative framework of endogenous and exogenous signals is presented, emphasizing their complementary roles in balancing safety, specificity, and sensitivity. Finally, the opportunities and challenges of multinuclear magnetic resonance are critically evaluated, including limitations in sensitivity, signal-to-noise ratio, data interpretation in heterogeneous systems, and technical complexity. Emerging directions such as ultrahigh-field imaging, advanced RF technologies, hyperpolarization, and artificial intelligence-assisted reconstruction are discussed as key drivers for future development. Overall, multinuclear NMR and MRI represent a powerful and expanding toolbox for probing complex material and biological systems, with the potential to significantly enhance diagnostic capabilities and deepen our understanding of structure–function relationships across multiple scales. Full article

Background/Objectives: Silver nanoparticles (AgNPs) are highly valuable nanomaterials due to their unique optical and physicochemical properties. AgNPs have a lot of promise as contrast-enhancing and diagnostic agents in image-guided treatment. With a focus on their incorporation into image-guided and theranostic approaches, this narrative review attempts to assess the current function of AgNPs in imaging diagnostics. Methods: Using major scientific databases, such as PubMed, Web of Science, and Scopus, a narrative literature review has been conducted with an emphasis on recent preclinical and experimental research examining AgNP-based systems for diagnostic imaging applications. The design of the NPs, surface functionalization, imaging modality, and diagnostic performance of the evaluated studies were analyzed. Results: Due to their surface plasmon resonance and tunable physicochemical properties, AgNPs show great promise in a variety of imaging techniques, such as optical imaging, computed tomography (CT), and multimodal platforms, according to the reviewed literature. Functionalized AgNPs emerged as agents in image-guided therapy due to their improved target selectivity, enhanced imaging contrast, and signal amplification in tissues. Conclusions: AgNPs are appealing nanoscale platforms for image-guided methods and imaging diagnostics. Despite their encouraging preclinical results, some key issues, such as toxicity, biocompatibility, and clinical translation, remain critical. AgNP-based therapeutic and diagnostic systems will need to overcome these constraints in the future. Full article

Radiopharmaceutical Theranostics defines the combination of molecularly targeted imaging and therapy in two consecutive phases. Targeted theranostic approaches are most established for the management of advanced prostate, thyroid and hepatocellular cancer, as well as neuroendocrine tumors (NETs). Adrenal malignancies present a complex challenge, requiring highly specialized management. The two primary entities addressed by targeted radiotheranostics—pheochromocytoma/paraganglioma (PPGL) and adrenocortical cancer (ACC)—consist of fundamentally distinct molecular targets and, consequently, different radiopharmaceutical agents. While most existing literature focuses on nuclear medicine–driven perspectives, the implications of theranostic advances for surgical decision-making remain underexplored. This narrative review aims to integrate available clinical evidence with multidisciplinary practice considerations, in reshaping the role of surgery in adrenal malignancies. Full article

Rare-earth elements (REEs), which include the entire lanthanide series together with scandium and yttrium, have unique electronic configurations and coordination chemical properties that provide them with special magnetic, optical, and redox abilities. Generally used for diagnostic imaging and theranostic applications, increasing evidence emphasizes their potential as direct anticancer agents. This review aims to present a thorough investigation of the studies published in the last ten years that focus on the intrinsic anticancer properties of REE-based molecular complexes and nanostructures, without discussing their recognized imaging functions. Rare-earth compounds exhibit selective cytotoxicity against malignant cells via mechanisms that mainly include modulations in the generation of reactive oxygen species, mitochondrial dysfunctions, interaction with DNA molecules, apoptosis, and ferroptosis induction, as well as radiosensitization. Molecular complexes that are based on the trivalent coordination chemistry of REEs enable them to target biomolecules like DNA and serum albumin. Nanostructured systems, on the other hand, render tumors more responsive to treatment by improving the cellular uptake, enabling surface functionalization, and controlling ROS generation. Terbium, thulium, yttrium, scandium, ytterbium, cerium, erbium, dysprosium, and europium show different levels of anticancer activity in both in vitro and in vivo cancer models. They often exert more toxicity in tumor cells than in normal tissues, thus exhibiting selective anticancer effects. The findings collectively underscore the therapeutic potential of REE-based compounds as novel metal-based anticancer agents and advocate for additional mechanistic and translational research to enhance their clinical applicability. Full article

Iron oxide nanoparticles have emerged as multifunctional compounds with prominent potential in cancer theranostics, particularly in photothermal therapy (PTT) and photodynamic therapy (PDT). Their unique electronic and crystal structures, such as the dispersion of Fe²⁺ and Fe³⁺ ions and d-orbital splitting, contribute to their magnetic and catalytic properties. In PTT, Fe₃O₄ nanoparticles exhibit moderate near-infrared (NIR) absorption and photothermal conversion efficiency, which can be enhanced through adjustments in particle size, surface modification, and combinations with other components. In PDT, Fe₃O₄ nanoparticles demonstrate intrinsic peroxidase-like catalytic activity, facilitating Fenton and photo-Fenton reactions that generate reactive oxygen species (ROS), including hydroxyl radicals (^•OH), thereby amplifying oxidative stress in cancer cells. These nanoparticles can also function as carriers for photosensitisers (PS), promoting targeted delivery and enhanced ROS generation. Multifunctional nanomaterials that integrate Fe₃O₄ with other therapeutic agents and targeting ligands have demonstrated synergistic antitumour effects through amplified photothermal, photodynamic, chemodynamic, and chemotherapeutic mechanisms. Despite certain drawbacks, such as relatively low NIR absorption and challenges in optimising delivery and light activation, ongoing improvements in Fe₃O₄-based nanoplatforms present significant potential for enhancing treatment outcomes and the precision of cancer therapy. This article systematically explores the synergistic role of Fe₃O₄ nanoparticles in PTT and PDT, encompassing their magnetic and catalytic characteristics. Additionally, it focuses on multifunctional hybrid nanoplatforms that combine Fe₃O₄ with targeting or imaging agents, highlighting their potential to enhance therapeutic precision. Full article

Gold nanoparticles (AuNPs) have been extensively studied in cancer treatment research since they have special physicochemical characteristics such as facile surface functionalization with various chemical groups, low toxicity, favorable biocompatibility, and the ability to passively accumulate in tumors through the enhanced permeability and retention (EPR) effect. Prostate cancer cells exhibit an overexpression of the Prostate-Specific Membrane Antigen (PSMA), which therefore represents an ideal candidate for the development of nanoplatforms targeting PSMA overexpressed on these cells. Lutetium-177 (¹⁷⁷Lu) is a β-particle emitter with a half-life of 6.7 days. This radionuclide is very promising for the development of theranostic platforms as it emits β⁻ particles, which are suitable for therapy, and γ-photons, capable of SPECT imaging. The combination of ¹⁷⁷Lu with AuNPs functionalized with PSMA for targeted delivery offers a promising tool for both diagnosis and therapy of prostate cancer. In this study, we focused on the synthesis and in vitro evaluation of PSMA-targeted AuNPs radiolabeled with ¹⁷⁷Lu. The AuNPs were functionalized with the TADOTAGA chelator, which enables effective radiolabeling with the radiometal, as well as with a PSMA molecule, which comprises the PSMA targeting moiety (vehicle) of the nanoconstruct. Radiolabeling of the functionalized AuNPs with ¹⁷⁷Lu was fast and robust. Subsequent studies focused on the in vitro stability and cellular interaction with two prostate cancer cell lines with different PSMA expression levels, in both 2D and 3D cell cultures, to assess effective targeting. Results indicate that radiolabeled AuNPs exhibit selective interaction with PSMA-expressing cells and present a stronger in vitro cytotoxic effect when functionalized with the PSMA molecule, confirming their potential as theranostic agents and warranting further investigation in LNCaP tumor-bearing mice. Full article