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Nuklearmedizin
DOI: 10.1055/a-2784-7716
Review

Radioactive Gold Isotopes in the Era of Theranostics: Medical Potential of ¹⁹⁸Au and ¹⁹⁹Au Radioisotopes

Radioaktive Goldisotope im Zeitalter der Theranostik: Medizinisches Potenzial der Radioisotope ¹⁹⁸Au und ¹⁹⁹Au

Authors

  • Punita Bhardwaj

    1   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Nuclear Medicine Department, Berlin, Germany (Ringgold ID: RIN14903)

  • Guilhem Claude

    1   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Nuclear Medicine Department, Berlin, Germany (Ringgold ID: RIN14903)

  • Winfried Brenner

    1   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Nuclear Medicine Department, Berlin, Germany (Ringgold ID: RIN14903)

  • Sarah Spreckelmeyer

    1   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Nuclear Medicine Department, Berlin, Germany (Ringgold ID: RIN14903)
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Abstract

Aim

Radioactive gold isotopes, particularly the element-matched theranostic pair 198Au and 199Au, hold significant promise for targeted radionuclide therapy and SPECT imaging. This review critically evaluates their medical potential by contextualizing historical development, nuclear properties, production physics, radiochemical separations, and contemporary radiopharmaceutical applications to identify pathways for clinical translation.

Methods

We comprehensively surveyed literature on gold isotope decay characteristics, reactor and accelerator based production from Au, Pt, and Hg targets, purification strategies including ion-exchange chromatography, solid-phase extraction, polymer/zeolite adsorption, and liquid-liquid extraction, alongside reviewing a spectrum of 198Au/199Au radiotracers from small-molecule complexes to nanostructures and bioconjugates.

Results

198Au and 199Au offer complementary β− emissions for therapy and their γ photons are ideal for SPECT imaging, with scalable carrier-added production routes from 197Au and non-carrier-added routes via enriched Pt/Hg. Robust separation techniques deliver radioactive gold with higher purity, enabling the production of diverse agents including but not limited to Au(III) Schiff-bases, phosphine/dithiocarbamate/NHC complexes, thioglucose derivatives, intrinsically doped nanoparticles (RGD-, bombesin-, HER2-targeted), and antibody conjugates.

Conclusion

While radioactive gold research has progressed from colloidal 198Au brachytherapy to modern small molecule based complexes, barriers persist in sustainable high-specific-activity production, target recycling, in vivo stability, and clinical validation. Nevertheless, gold's chemical and physical characteristics position 198Au/199Au as candidates for next-generation radio-theranostics.

Keywords

theranostics - radioactive gold - ¹⁹⁸Au - ¹⁹⁹Au - nuclear medicine - radiopharmaceuticals


Publication History

Received: 08 December 2025

Accepted: 19 December 2025

Article published online:
02 February 2026

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