Theranostic Imaging Agents: Integrating Molecular Diagnostics, Precision Therapeutics, and Artificial Intelligence
4 affiliations
- 1Amity Institute of Pharmacy, Amity University, Gurugram 122413, Haryana, India
- 2Clinical Pharmacy & Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
- 3Department of Pharmacy, Jagannath University, Bahadurgarh 124507, Haryana, India
- 4Geeta Institute of Pharmacy, Geeta University, Naultha, Panipat 132145, Haryana, India
Abstract
Theranostic imaging agents combine molecular diagnosis, targeted therapy and monitoring of treatment response into a single paradigm of precision medicine. This review summarizes the current development and translational landscape of theranostic imaging agents, covering molecular targets, imaging platforms, principles of agent design, nanotheranostics, radiotheranostics, and disease-specific applications. Particular emphasis is given to clinically validated and emerging targeting strategies using prostate-specific membrane antigen, somatostatin receptors, fibroblast activation protein, C-X-C Chemokine Receptor 4 (CXCR4), Human Epidermal Growth Factor Receptor 2 (HER2) and other disease-associated biomarkers. Moreover, the review addresses Positron Emission Tomography (PET), Single-Photon Emission Computed Tomography (SPECT), Magnetic Resonance Imaging (MRI), optical, photoacoustic, Raman and multimodal imaging approaches, therapeutic payloads, stimulus-responsive systems, and pharmacokinetic optimization. Moreover, emerging applications of artificial intelligence, radiomics, radiogenomics, spatial and single-cell multiomics, liquid biopsy, digital pathology, personalized dosimetry, and digital twins are evaluated for their potential to improve patient stratification, treatment selection, response assessment and adaptive therapy. Despite tremendous progress, clinical translation is hampered by target heterogeneity, off-target accumulation, radionuclide availability, manufacturing complexity, dosimetric uncertainty, regulatory requirements, limited clinical validation, data interoperability, cost and unequal access. This review, overall, emphasizes the convergence of molecular imaging, targeted therapeutics, nanotechnology, and artificial intelligence in the development of next-generation theranostic platforms, and outlines critical priorities for their clinical translation.
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BibTeX
@article{sharma2026theranostic,
title = {{Theranostic Imaging Agents: Integrating Molecular Diagnostics, Precision Therapeutics, and Artificial Intelligence}},
author = {Shrestha Sharma and Syed Arman Rabbani and Mohamed El-Tanani and Mohamedanas Mohamedfaruk Patni and Rakesh Kumar and Manita Saini},
journal = {Biomolecules},
year = {2026},
month = oct,
doi = {10.3390/biom16101515},
url = {https://www.mdpi.com/2218-273X/16/10/1515},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Theranostic Imaging Agents: Integrating Molecular Diagnostics, Precision Therapeutics, and Artificial Intelligence
AU - Shrestha Sharma
AU - Syed Arman Rabbani
AU - Mohamed El-Tanani
AU - Mohamedanas Mohamedfaruk Patni
AU - Rakesh Kumar
AU - Manita Saini
PY - 2026
DA - 2026/10/01
JO - Biomolecules
DO - 10.3390/biom16101515
UR - https://www.mdpi.com/2218-273X/16/10/1515
AB - Theranostic imaging agents combine molecular diagnosis, targeted therapy and monitoring of treatment response into a single paradigm of precision medicine. This review summarizes the current development and translational landscape of theranostic imaging agents, covering molecular targets, imaging platforms, principles of agent design, nanotheranostics, radiotheranostics, and disease-specific applications. Particular emphasis is given to clinically validated and emerging targeting strategies using prostate-specific membrane antigen, somatostatin receptors, fibroblast activation protein, C-X-C Chemokine Receptor 4 (CXCR4), Human Epidermal Growth Factor Receptor 2 (HER2) and other disease-associated biomarkers. Moreover, the review addresses Positron Emission Tomography (PET), Single-Photon Emission Computed Tomography (SPECT), Magnetic Resonance Imaging (MRI), optical, photoacoustic, Raman and multimodal imaging approaches, therapeutic payloads, stimulus-responsive systems, and pharmacokinetic optimization. Moreover, emerging applications of artificial intelligence, radiomics, radiogenomics, spatial and single-cell multiomics, liquid biopsy, digital pathology, personalized dosimetry, and digital twins are evaluated for their potential to improve patient stratification, treatment selection, response assessment and adaptive therapy. Despite tremendous progress, clinical translation is hampered by target heterogeneity, off-target accumulation, radionuclide availability, manufacturing complexity, dosimetric uncertainty, regulatory requirements, limited clinical validation, data interoperability, cost and unequal access. This review, overall, emphasizes the convergence of molecular imaging, targeted therapeutics, nanotechnology, and artificial intelligence in the development of next-generation theranostic platforms, and outlines critical priorities for their clinical translation.
SN - 2218-273X
ER -