Across 215 unique radiopharmaceutical Phase I–III trials, the European footprint includes 540 named sites, 1,786 country-level site slots, 22,126 planned country-level participants, and 19 countries. Universitaetsklinikum Essen AöR leads individual site participation with 23 of 215 trials, while France leads both country-level site slots with 417 of 1,786 and planned participants with 5,128 of 22,126.
The top 10 named sites account for 190 of 1,623 site-trial participations, or 11.7%. Universitaetsklinikum Essen AöR ranks first with 23 of 215 trials, followed by Hospital Universitario 12 De Octubre with 22 of 215.
The highest-frequency sites are concentrated in Germany, Spain, France, and Belgium, indicating that repeat radiopharmaceutical trial participation is anchored in a small group of nuclear medicine and oncology-capable academic centers rather than evenly distributed across the full 540-site network.
France leads the site footprint with 417 of 1,786 country-level site slots, or 23.3%. Spain follows with 315 site slots, Germany with 229, the Netherlands with 211, and Italy with 174; together, these five countries contribute 1,346 of 1,786 site slots, or 75.4%.
Radiopharmaceutical trial site selection is highly concentrated: the top five countries provide three quarters of all country-level site slots. This suggests that sponsors repeatedly rely on countries with established imaging, nuclear medicine, oncology, and trial operations infrastructure.
France accounts for 5,128 of 22,126 planned country-level participants, or 23.2%. The Netherlands ranks second with 3,203 participants despite ranking fourth by site slots, while Spain ranks third with 2,978 participants.
| Country | Participants | Share | Sites |
|---|---|---|---|
| France | 5,128 | 23.2% | 417 |
| Netherlands | 3,203 | 14.5% | 211 |
| Spain | 2,978 | 13.5% | 315 |
| Italy | 2,655 | 12.0% | 174 |
| Sweden | 1,907 | 8.6% | 61 |
| Germany | 1,814 | 8.2% | 229 |
| Belgium | 1,616 | 7.3% | 106 |
| Poland | 923 | 4.2% | 115 |
Country rank by participants does not exactly mirror site rank. The Netherlands contributes 14.5% of planned participants but 11.8% of site slots, while Spain contributes 17.6% of site slots but 13.5% of participants, indicating different site-density and enrolment-intensity profiles.
Oncology is the dominant therapeutic area, appearing in 136 of 215 trials, or 63.3%. Neurology appears in 38 trials, or 17.7%, while “Other” appears in 39 trials, or 18.1%. The most frequent disease tags are Alzheimer’s disease and breast cancer, each appearing in 15 of 215 trials.
Radiopharmaceutical trial demand is not limited to prostate cancer. Oncology still dominates, but Alzheimer’s disease, Parkinson’s disease, breast cancer, lung cancer, pancreatic cancer, and colorectal cancer create a multi-specialty site model spanning nuclear medicine, oncology, neurology, urology, and imaging-capable departments.
Phase II is the largest activity layer, with 125 of 215 trials, or 58.1%. Phase III appears in 72 trials, or 33.5%, and Phase I appears in 52 trials, or 24.2%.
The radiopharmaceutical pipeline is weighted toward Phase II, where sponsors need enough specialized sites to test signal, dosimetry, imaging logistics, and operational feasibility before larger Phase III expansion.
Radiopharmaceutical site planning should prioritize repeat-capable centers and the highest-density country corridors. The top 10 countries contribute 1,690 of 1,786 country-level site slots, or 94.6%, while the top five participant countries contribute 15,871 of 22,126 planned participants, or 71.7%.
At country level, radiopharmaceutical trials are highly concentrated; at individual site level, participation is broader. This makes country selection the first major operational lever, while individual site selection should balance repeat radiopharmaceutical experience with indication-specific capacity.