Targeted deposition, controlled activation, and real-time treatment response monitoring are made possible by radiology-guided drug delivery systems, which combine medical imaging with engineered carriers to increase the spatial and temporal accuracy of therapy. The main imaging modalities like X-ray/fluoroscopy, computed tomography, magnetic resonance imaging, and ultrasound are summarized in this review along with their respective contributions to navigation, anatomical localization, functional or molecular guidance, and, on some platforms, triggerable release. Major delivery platforms, including nanoparticles, liposomes/micelles, ultrasound-responsive microbubbles, catheter-based systems, and stimuli-responsive formulations, are discussed, with emphasis on design features that support image visibility and selective activation. Particular attention is given to radiology-triggered strategies such as ultrasound- and radiofrequency-mediated effects and radiotherapy-triggered release, where imaging enables verification and adaptive control. Toxicological safety is addressed through biodistribution, clearance, acute versus chronic risk, modality-specific hazards (e.g., radiation exposure, thermal effects, cavitation), and the added complexity of combination-product regulation. Preclinical evaluation frameworks incorporating imaging-based pharmacokinetics and pharmacodynamics are examined, along with translational barriers including standardization, manufacturing scalability, infrastructure demands, ethics and consent, and evolving regulatory oversight, especially as intelligent radiology systems emerge. Overall, evidence indicates the strongest clinical momentum in oncology, with expanding opportunities in vascular, neurologic, and inflammatory indications. Standardized workflows, rigorous safety science, and clear regulatory pathways are essential to translate radiology-guided delivery into broadly accessible precision medicine.
Keywords: radiology-guided drug delivery; theranostics; stimuli-responsive nanocarriers; imaging-triggered therapy; toxicological safety
How to cite this article: Padmavathi V, Chaudhary M, Gharal RR, Solanki RN, Singh SI, Shukla AK, Radiology-Guided Drug Delivery Systems: Toxicological Safety and Clinical Applications in Modern Medicine. Int J Drug Deliv Technol. 2026;16(4s): 525-536; DOI: 10.25258/ijddt.16.4s.63
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Conflict of interest: None