Molecular imaging radiologist jobs for theranostics programs

Molecular imaging radiologist jobs for theranostics programs sit at the intersection of diagnostic nuclear medicine and radiopharmaceutical therapy, and hiring for them looks nothing like a standard diagnostic radiology search in 2026. A general PET/CT reading job asks you to interpret; a theranostics job asks you to interpret, dose, and manage the patient through a therapy cycle — which means the credentialing bar, the interview questions, and the contract terms all shift.

Why theranostics jobs matter for molecular imaging radiologists

A diagnostic radiologist who reads a PSMA PET scan and stops there is doing half the job a theranostics program needs filled in 2026. Health systems that built out radioligand therapy suites after Lutathera's 2018 approval and Pluvicto's 2022 approval are now hiring physicians who can read the staging scan, sign as the Authorized User on the therapy dose, and manage the patient across multiple treatment cycles.

That's a different hire than a general nuclear medicine opening. Search RadBoard and you'll see molecular imaging listings split cleanly into two buckets: diagnostic-only PET/SPECT reading and combined diagnostic-plus-therapy roles that specifically name Lutathera, Pluvicto, or radioligand therapy in the posting. Knowing which bucket a job falls into before you interview saves you a wasted conversation.

The credentialing difference is the real filter. A general diagnostic radiologist without AU status can't administer therapy no matter how strong their PET/CT reading is, which is exactly why theranostics postings screen harder and pay attention to your nuclear medicine training pathway before anything else.

Confirm your Authorized User status pathway

Before you apply to a single theranostics posting, know which AU pathway you're on — it determines which jobs will even consider your application.

• Check whether your training satisfies 10 CFR 35.390 (AU for unsealed byproduct material) or your state's equivalent agreement-state regulation.
• Confirm your ABR nuclear medicine subspecialty certificate or ABNM board certification is current and matches the isotopes the program uses.
• List every therapeutic radionuclide you've administered supervised cases for — 177Lu, 131I, 90Y — since programs ask for case logs, not just a certificate.
• If you're short on supervised cases, look at dual board certification in nuclear medicine pathways before your job search rather than during it.
• Verify reciprocity if you're licensed in a different state than the program — agreement states don't automatically honor each other's AU designations.

Target health systems actually building radioligand therapy programs

Not every hospital with a PET scanner is hiring for theranostics — narrow your list to systems with a live radiopharmaceutical therapy suite.

• Cancer centers with dedicated NET (neuroendocrine tumor) or prostate cancer programs, since Lutathera and Pluvicto both require oncology-integrated infrastructure.
• Academic centers running phase II/III radioligand therapy trials, which often hire molecular imaging radiologists specifically for trial-compliant dosimetry.
• Freestanding molecular imaging clinics that added a hot lab and dosing suite in the last two to three years.
• Multi-hospital systems consolidating theranostics into one regional hub rather than staffing every site.
• Community hospitals that partner with an academic center for therapy delivery but need a local reading physician.

Build a subspecialty niche recruiters can actually find

A CV that reads "nuclear medicine" gets sorted with every other applicant — a CV that names the isotopes, the disease states, and the case volume gets shortlisted.

• State your case volume for PSMA PET, DOTATATE PET, and any therapy administrations by year, not by "extensive experience."
• Name every disease state you've staged or treated for: prostate cancer, neuroendocrine tumors, thyroid cancer.
• Include dosimetry and radiation safety committee work if you've done it — programs weight this heavily for AU sign-off.
• List conference presentations or CME specific to radioligand therapy from 2024 through 2026.
• If your training was diagnostic-heavy, name the pathway you used to add therapy competency, don't leave the gap unexplained.

Search AI-matched postings instead of scrolling generic boards

Generic job boards bury theranostics postings inside a general "nuclear medicine" category, which means you're reading dozens of PET/SPECT-only listings to find the two that mention radioligand therapy.

• Search by isotope name ("Lutathera," "Pluvicto," "177Lu") instead of just "nuclear medicine radiologist."
• Filter for "Authorized User required" or "AU status" in the posting text, which most diagnostic-only jobs won't include.
• Save postings that mention dosimetry, hot lab, or radiopharmaceutical therapy suite as you find them rather than bookmarking generically.
• Use an AI-powered search that reads full job descriptions instead of keyword-matching titles — RadBoard's swipe-to-save search pulls from 20 sources and surfaces theranostics-specific language that a plain keyword search on a single hospital career page misses.
• Cross-check against nuclear medicine radiologist jobs for PET and SPECT readers if you're still deciding between diagnostic-only and combined-scope roles.

Negotiate scope, call, and dosimetry support before signing

Theranostics contracts carry terms a standard diagnostic job doesn't — negotiate them explicitly instead of assuming they're standard.

• Ask who covers dosimetry calculations: you, a medical physicist, or a shared radiation safety office.
• Confirm whether therapy administration counts toward RVU targets the same as diagnostic reads, since some contracts undercount it.
• Clarify call coverage for post-therapy complications — this is a different call burden than diagnostic-only nights.
• Get radiation safety officer support and hot lab staffing written into the offer, not just implied.
• Confirm CME allowance covers radioligand therapy-specific conferences, which run separately from general radiology CME.

Decide between diagnostic-only and diagnostic-plus-therapy roles

The two job types pay differently, credential differently, and burn out differently — pick deliberately.

• Diagnostic-only PET/SPECT roles need ABR or ABNM certification but not AU status, and generally carry lighter call.
• Diagnostic-plus-therapy roles need AU status, carry therapy administration liability, and usually pay a premium reflecting the added scope.
• If you want to keep growing your therapy case count for future AU pathways, plus-therapy roles build that log faster.
• If you want subspecialty-only reading without procedural liability, a diagnostic-only molecular imaging role keeps you out of the dosing suite entirely.

Track credentialing renewal deadlines once you're hired

AU status and state licensure both lapse on fixed timelines — missing one halts your ability to administer therapy mid-contract.

• Calendar your AU renewal date the day you start, not the week before it expires.
• Track continuing education hour requirements specific to radiation safety, separate from general CME.
• Confirm your employer's radiation safety committee reviews AU status annually and flags renewals in advance.
• Keep a running log of therapy administrations for any future multi-state or academic AU applications.

Comparison: where theranostics-trained radiologists actually work

Verdict: an academic cancer center theranostics program is the strongest fit for a molecular imaging radiologist building AU case volume in 2026 — the trade-off is a slower offer timeline than a PE-backed chain.

Common mistakes molecular imaging radiologists make in this search

• Applying before confirming AU status — recruiters screen this first, and a strong PET/CT reading record doesn't substitute for an active Authorized User designation.
• Treating "nuclear medicine job" as one category — diagnostic-only and diagnostic-plus-therapy postings get lumped together on generic boards, and applying to the wrong bucket wastes an interview slot.
• Underselling case volume — writing "experience with radioligand therapy" instead of stating actual Lutathera or Pluvicto administration counts by year.
• Skipping the dosimetry question in interviews — not asking who calculates dose and who signs off leaves you discovering the answer after you've signed.
• Assuming AU status transfers across state lines automatically — agreement states don't universally recognize each other's designations, and this surfaces late in credentialing if you don't check first.

FAQ

One last thing

Most molecular imaging radiologists searching in 2026 filter by "nuclear medicine" and miss postings that never use that phrase — programs increasingly title these roles "radioligand therapy physician" or "theranostics attending" instead. Search by isotope name and drug brand, not just specialty label, and you'll surface listings a keyword-only search on a hospital career page won't show.

Related guides

• Nuclear medicine radiologist jobs for PET and SPECT readers
• PET-CT radiologist jobs for oncologic staging reads
• Radiology jobs supporting clinical trials and pharma imaging labs