Radiopharmaceutical Compendium
An interactive tracer/target matrix, every major radiopharmaceutical by isotope, modality, mechanism, and use
Quick Answer
Nuclear medicine is organized less by organ than by what a tracer targets. This compendium is a single interactive view of the field's molecular toolkit: every major radiopharmaceutical mapped to its isotope, imaging or therapeutic modality, biological mechanism, molecular target, and primary use. Filter by mechanism class (perfusion, metabolism, receptor, antigen, transporter, bone, and so on) or by modality (PET, SPECT, therapy), search by target or indication, and click any agent to open its full page. It is the fastest way to see the whole landscape at once — and to grasp the mechanism-based logic that makes the field coherent.
How to use it
Read the table as a map of mechanism, not anatomy. Agents that share a mechanism class behave alike wherever they are used: transporter tracers (iodide via NIS, MIBG via the norepinephrine transporter, ioflupane via DAT, FDOPA via the catecholamine pathway) all exploit a specific uptake pump; receptor/antigen tracers (DOTATATE→SSTR, PSMA ligands, FES→ER) bind a molecular target that also defines a matched therapy; perfusion agents trace blood flow; metabolism agents trace a metabolic pathway. Seeing tracers grouped this way is what turns a long list of names into a system — and it is why every future radiopharmaceutical slots into an existing mechanism class.
Reading the theranostic pairs
The compendium makes the theranostic pairs visible at a glance: an imaging tracer and a therapy that share the same target. SSTR imaging (⁶⁸Ga-DOTATATE) pairs with ¹⁷⁷Lu-DOTATATE therapy; PSMA imaging pairs with ¹⁷⁷Lu- and ²²⁵Ac-PSMA; NIS imaging (radioiodine) pairs with ¹³¹I therapy; the norepinephrine transporter pairs ¹²³I-MIBG imaging with ¹³¹I-MIBG therapy. The principle is universal: the therapy can only treat what the imaging agent shows expresses the target — which is why target-negative disease (detected by a second tracer such as FDG) predicts treatment failure.
Self-Check
Q1. Why is organizing radiopharmaceuticals by mechanism class more durable than organizing by organ?
Answer: Agents that share a mechanism (transporter, receptor, perfusion, metabolism…) behave alike wherever used, and every new tracer slots into an existing class — so a mechanism-based scheme scales without reorganization, whereas organ-based lists fragment the same biology across chapters.
Q2. Name the imaging–therapy target for three theranostic pairs.
Answer: SSTR (⁶⁸Ga-DOTATATE ↔ ¹⁷⁷Lu-DOTATATE); PSMA (PSMA PET ↔ ¹⁷⁷Lu-/²²⁵Ac-PSMA); NIS (radioiodine imaging ↔ ¹³¹I therapy); and the norepinephrine transporter (¹²³I-MIBG ↔ ¹³¹I-MIBG).
Q3. Which mechanism class do radioiodine, MIBG, ioflupane, and FDOPA all belong to, and what unites them?
Answer: The transporter/uptake class — each exploits a specific membrane transport pathway (NIS, the norepinephrine transporter, the dopamine transporter, and the catecholamine/AADC pathway, respectively).
Q4. What does target-negative disease on a second tracer (e.g. FDG) imply for a theranostic pair?
Answer: It predicts treatment failure for the target-directed therapy — the therapy only irradiates cells expressing the target, so target-negative but metabolically active disease is left untreated (the PSMA/FDG and SSTR/FDG discordance concept).
Key References
- SNMMI/EANM procedure guidelines for the individual agents listed; radiopharmaceutical target/mechanism reviews.
- The mechanism-based organization mirrors this atlas's Domain II (Probes & Targets) framework.
Evidence & sources
https://nuc.med/radiopharmaceutical-compendium/ Report an issue