RT Journal Article SR Electronic T1 Theranostics in Perspective: White Paper JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP jnumed.125.269776 DO 10.2967/jnumed.125.269776 A1 Stokkel, Marcel P.M. A1 Gotthardt, Martin A1 Herrmann, Ken A1 Gnanasegaran, Gopinath YR 2025 UL http://jnm.snmjournals.org/content/early/2025/05/15/jnumed.125.269776.abstract AB Nuclear medicine has evolved from a diagnostic-oriented speciality toward theranostics. Radionuclide therapy has become a booming business with newer radiopharmaceuticals and indications. Although the specialty of nuclear medicine seems scintillating, several challenges might limit sustained and long-term success. Some of the challenges and issues requiring clarification include radiopharmaceutical cost and supply, cost–benefit analysis, reimbursement, training, workforce, collaboration with the radiopharmaceutical industry, national and international nuclear medicine, and applied specialities. This review discusses these challenges and possible solutions to avoid speed breakers in theranostics.