Radio conjugated nanoparticles for cancer theranostics: Advances in targeted imaging and radiotherapy

Cancer remains one of the most challenging diseases worldwide due to limitations in conventional diagnostic and therapeutic approaches, including non-specific targeting, multidrug resistance, and systemic toxicity. The integration of nanotechnology with radiopharmaceutical science has given rise to radio conjugated nanoparticles (RNPs)—multifunctional platforms that combine molecular imaging and targeted radiotherapy within a single system. These nanoscale constructs, engineered with diagnostic and therapeutic radionuclides, offer enhanced tumor localization, real-time monitoring, and improved therapeutic outcomes while minimizing off-target effects. This review provides a comprehensive overview of recent advances in the design, radiolabelling strategies, and surface modifications of RNPs aimed at achieving personalized cancer management. It discusses the selection of radionuclides, nanoparticle carriers, and targeting ligands, as well as analytical evaluation methods such as radiochemical purity, stability, and pharmacokinetics. Furthermore, the clinical translation challenges—including large-scale synthesis, regulatory frameworks, and long-term safety concerns—are critically examined. The review also explores multimodal imaging approaches, combination therapies, and the emerging role of artificial intelligence in enhancing diagnosis and treatment planning. This work consolidates current knowledge on RNPs, highlighting their transformative potential in precision oncology and future directions toward enhanced clinical translation and patient well-being.