Beta Atlas: Charting Global Production of Nonconventional β--Emitters for Targeted Radiopharmaceutical Therapy-Part 1.

Abstract

β-minus particle (β^-)-emitting radionuclides have long been central to targeted radiopharmaceutical therapy. Interest in expanding their repertoire beyond conventional options has grown over time, as the need for radionuclides with different emission profiles and theranostic potential becomes increasingly clear. Nonetheless, their clinical translation remains limited by production constraints, inconsistent clinical evidence supporting their use. By reporting the state of the art in nonconventional β^--radionuclide production, the current global landscape of production centers and reviewing current clinical evaluations, this β-atlas provides a critical overview of how these radionuclides may influence the future of targeted radiopharmaceutical therapy. This perspective is intended to support researchers, clinicians, and industry in recognizing both the opportunities and the constraints associated with integrating alternative β^--emitters into clinical practice. Ultimately, this β-atlas aims to serve as a strategic resource to foster collaboration and guide investment toward more reliable and scalable supply chains of nonconventional β^--emitters, thereby strengthening the foundation for future innovation in β^--based therapy. This review focuses on β^--emitters that have already progressed to clinical evaluation, including ⁶⁷Cu, ¹⁵³Sm, ¹⁶¹Tb, ¹⁶⁶Ho, ¹⁸⁶Re, and ¹⁸⁸Re.