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[43Sc]DOTATATE is a novel positron emission tomography (PET) radiopharmaceutical imaging agent under preclinical development for the diagnosis of somatostatin receptor subtype 2 (SSTR2)-positive neuroendocrine neoplasms (NENs). It consists of the somatostatin analogue tyrosine-3-octreotate (TATE) conjugated to the chelator DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) and radiolabeled with the positron-emitting isotope scandium-43 (43Sc). Scandium-43 offers a longer half-life (3.89 hours) compared to the standard gallium-68 (68 minutes), allowing for extended imaging windows and centralized production. It forms a true theranostic pair with the therapeutic beta-emitter scandium-47 ([47Sc]DOTATATE) due to identical coordination chemistry and pharmacokinetics. Preclinical studies demonstrate robust, highly specific uptake and internalization in SSTR2-expressing neuroendocrine tumor cells and xenograft models.
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