Originally, nuclear medicine focused on radiopharmaceuticals trapped in organ structures, based on their function, and the presence of disease was seen by the absence of radioactivity. More recently, target-specific radiopharmaceuticals have been developed to visualize and/or treat oncological diseases. Since radiopharmaceuticals have historically a leading position in the search for “molecular imaging”, it would be a waste not to learn from the pitfalls and opportunities that have been and are found during the development of radiopharmaceuticals. This knowledge can be used in the improvement of contrast agents for other imaging modalities like MRI and CT. In this article the aspects that are needed for the use of current and future therapeutic and diagnostic radiopharmaceuticals are described. Especially the production and development of therapeutic and imageable radiopharmaceuticals are demonstrated. MRI or CT can sometimes also image stable isotopes of elements that contain useful radionuclides. This can result in real multimodality imaging. Combining imaging modalities and imaging agents will result in better patient care and can only be advantageous if all departments and institutes will collaborate on their research work. The combination of approaches together with the fast progress in developments in the medical imaging world will result in a bright future for imaging driven therapy of cancer.