11 Positron Emission Tomography (PET) Driven Theranostics

“Theranostics” or “theragnostics” is a concept combining therapy and diagnostics, particularly in vivo to maximize efficient delivery of targeted therapeutic agents to the tumors. It enables “personalized medicine”, meaning that the therapy is tailored to the needs of a given patient. Diagnostic imaging has also a great role in the monitoring of therapy, because continuation or change of treatment plan can be decided based on the information about the tracer accumulation in the tumors. In this chapter we briefly describe positron emission tomography-based theranostics in cancer treatment and diagnosis, with a focus on metal-based agents. The chapter will cover the thermodynamics, formation and dissociation kinetics of metal ion-based radiopharmaceuticals for the selection of optimal chelates for the complexation of radiometals and the development of novel and more effective cancer specific theranostic agents.