Neuroblastoma (NB) represents the most common extracranial tumor of childhood. Prognosis
is quite variable, ranging from spontaneous regression to aggressive behavior with wide
metastatization, high mortality, and limited therapeutic options. Radiotheranostics combines a
radiopharmaceutical pair in a unique approach, suitable both for diagnosis and therapy. For many
years, metaiodobenzylguanidine (MIBG), labeled with 123I for imaging or 131I for therapy, has represented
the main theranostic agent in NB, since up to 90% of NB incorporates the aforementioned
radiopharmaceutical. In recent years, novel theranostic agents hold promise in moving the field
of NB radiotheranostics forward. In particular, SarTATE, consisting of octreotate targeting somatostatin
receptors, has been applied with encouraging results, with 64Cu-SARTATE being used for
disease detection and with 67Cu-SARTATE being used for therapy. Furthermore, recent evidence
has highlighted the potential of targeted alpha therapy (TAT) for treating cancer by virtue of alpha
particles’ high ionizing density and high probability of killing cells along their track. On this path,
211At-astatobenzylguanidine (MABG) has been developed as a potential agent for TAT and is actually
under evaluation in preclinical NB models. In this review, we performed a web-based and desktop
literature research concerning radiotheranostic approaches in NB, covering both the radiopharmaceuticals
already implemented in clinical practice (i.e.,123/1311-MIBG) and those still in a preliminary
or preclinical phase
