Advanced Theranostics (Tb-series)

Terbium radioisotopes offer a unique advantage in theranostics by providing a set of isotopes within the same element suitable for both diagnostic and therapeutic applications. In particular, Tb-152 and Tb-155 are well suited for diagnostic imaging, with Tb-152 used for positron emission tomography (PET) and Tb-155 for single-photon emission computed tomography (SPECT). Complementing these imaging isotopes, Tb-161 and Tb-149 can be used for targeted therapy, with Tb-161 acting as β--emitter and Tb-149 emitting α-particles for targeted alpha therapy. Together, these properties enable the development of matched radiopharmaceuticals, facilitating patient-specific diagnosis, optimized treatment planning, and accurate treatment monitoring within a single theranostic framework. Among these, Tb-161 is of particular interest due to its emission of low-energy β--particles and Auger electrons, which may improve therapeutic efficacy for small lesions and disseminated disease, an area of growing clinical relevance. However, the routine application of terbium-based radiopharmaceuticals remains constrained by challenges related to radionuclide production, target preparation, radiochemical processing, and quality control. In this context, significant capacity gaps persist in many Member States with respect to the development, production, and regulatory-compliant quality assurance of this emerging generation of therapeutic radiopharmaceuticals. The proposed Coordinated Research Project (CRP) on “Advanced Theranostics (Tb Series)” will address these challenges by supporting the development and harmonization of production routes, radiolabelling approaches, and quality control procedures, while strengthening technical expertise and capabilities in participating Member States, thereby enabling more equitable access to advanced theranostic technologies.