Molecular targeting requires assessing several factors that come into play such as the location of the target, the choice of radionuclide, the inertness of the bifunctional chelate and stability of the covalently bound halogens, matching the residence time in the tumor with the physical half-life of the radionuclide, the scale and scope of the disease, and the absorbed dose sensitivity of the targeted tumor compared to normal tissue. The principles of molecular targeting are well established, but a paradigm shift from designing a medium-affinity radiotracer used to determine target density to designing a high-affinity, high-target density radioligand to maximize the target-to-nontarget ratio should increase the probability of detecting lesions smaller than the instrument resolution.Developing and validating a therapeutic radiopharmaceutical for a single target is Keywords Alpha particles • Beta particles • Auger electrons • Molecular targeting • Therapeutic radionuclides • Theranostics • Double-strand breaks • Bystander effects • Residence time W.C. Eckelman (*) Molecular Tracer,