Terbium radionuclides for theranostic applications in nuclear medicine: from atom to bedside

Camille Van Laere, Michel Koole, Christophe M. Deroose, Michiel Van de Voorde, Kristof Baete, Thomas Elias Cocolios, Charlotte Duchemin, Maarten Ooms, Frederik Cleeren

Research outputpeer-review


Terbium features four clinically interesting radionuclides for application in nuclear medicine: terbium-149, terbium-152, terbium-155, and terbium-161. Their identical chemical properties enable the synthesis of radiopharmaceuticals with the same pharmacokinetic character, while their distinctive decay characteristics make them valuable for both imaging and therapeutic applications. In particular, terbium-152 and terbium-155 are useful candidates for positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging, respectively; whereas terbium-149 and terbium-161 find application in α- and β--/Auger electron therapy, respectively. This unique characteristic makes the terbium family ideal for the “matched-pair” principle of theranostics. In this review, the advantages and challenges of terbium-based radiopharmaceuticals are discussed, covering the entire chain from radionuclide production to bedside administration. It elaborates on the fundamental properties of terbium, the production routes of the four interesting radionuclides and gives an overview of the available bifunctional chelators. Finally, we discuss the preclinical and clinical studies as well as the prospects of this promising development in nuclear medicine.
Original languageEnglish
Pages (from-to)1720-1743
Number of pages24
Issue number4
StatePublished - 17 Feb 2024


SCK CEN Academy support is gratefully acknowledged. This research received support from Research Foundation – Flanders (FWO)-SBO project: Terbium Isotopes for Medical Applications in Flanders (Tb-IRMA-V) and FWO IRI project: Research on radioactive nuclei at ISOLDE-CERN, SPIRAL2-GANIL and MEDICIS-CERN (ISOLDE/SPIRAL2/ CERN, 3E221375). Christophe M. Deroose is a Senior Clinical Investigator at the FWO. The project received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 101008571 (PRISMAP – The European medical radionuclides program) and by internal funding KU Leuven.

FundersFunder number
Horizon Europe
Horizon Europe101008571
Fonds Wetenschappelijk OnderzoekSPIRAL2-GANIL
KU Leuven

    ASJC Scopus subject areas

    • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
    • Medicine (miscellaneous)

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