PT - JOURNAL ARTICLE AU - Laura Puentes AU - Mehran Makvandi AU - Robert Henry Mach TI - Molecular Imaging: PARP-1 and Beyond AID - 10.2967/jnumed.120.243287 DP - 2021 Feb 01 TA - Journal of Nuclear Medicine PG - jnumed.120.243287 4099 - http://jnm.snmjournals.org/content/early/2021/02/12/jnumed.120.243287.short 4100 - http://jnm.snmjournals.org/content/early/2021/02/12/jnumed.120.243287.full AB - The genetic code to life is balanced on a string of DNA that is under constant metabolic and physical stress from environmental forces. Nearly all diseases have a genetic component caused by or resulting in DNA damage that alters biology to drive pathogenesis. Recent advancements in DNA repair biology have led to the development of imaging tools that target DNA damage response and repair proteins. Positron-emission tomography (PET) has been used for early detection of oncogenic processes and monitoring tumor response to chemotherapeutics that target the DNA repair machinery. In the field of precision medicine, imaging tools provide a unique opportunity for patient stratification by directly measuring drug target expression or monitoring therapy to identify early responders. This overview discusses the state-of-the-art on molecular imaging of DNA damage and repair from the past 5 years, with an emphasis on poly [adenosine diphosphate (ADP) ribose] polymerase-1 (PARP-1) as an imaging target and predictive biomarker of response to therapy.