Radiolabelled nanomaterials for diagnostic and therapeutic applications in hepatocellular carcinoma and other liver diseases

Nuclear medicine plays a pivotal role in diagnosing and treating liver diseases such as hepatocellular carcinoma (HCC), fibrosis, and non-alcoholic steatohepatitis. Positron emission tomography (PET) and single photon emission computed tomography (SPECT) are key tools in nuclear medicine, offering reliable imaging capabilities and enabling radiotherapy. Radiolabelled nanomaterials uniquely integrate the advantages of nanomaterials with radionuclides, offering innovative solutions to the challenges posed by liver pathologies. This review examines advancements in this domain, beginning with the properties and classification of radionuclides and their integration with nanomaterials via diverse radiolabelling strategies. Furthermore, the hepatic targeting mechanisms applied in radiolabelled nanomaterials, including enhanced permeability and retention effects, hepatic reticuloendothelial system targeting, hepatic artery injection, and hepatic marker-based targeting, were explored. Key applications of radiolabelled nanomaterials in diagnostic imaging ( 18 F, 64 Cu, 68 Ga, and 99m Tc), therapeutic interventions ( 90 Y, 109 Pd, 125 I, and 198 Au), and theranostic platforms ( 131 I and 188 Re) are comprehensively summarized, highlighting their potential in liver diseases. Future prospects emphasize the development of advanced targeting technologies, emerging radionuclides, and personalized multimodal treatment approaches to address critical gaps in current clinical practice. • Nuclear medicine shows strong potential for diagnosing and treating liver diseases. • Radiolabelled nanomaterials combine nanomaterial advantages with radionuclides. • Nanomaterials enable precise liver-targeted radionuclide delivery. • Radiolabelled nanomaterials improve the diagnosis and therapy of liver diseases. • Future work aims at smarterly targeting and new radionuclides for precision medicine.