The innovation logic cycle of nuclear medicine: Translation, adoption, and reinvention across 130 years.

Nuclear medicine is often narrated as a chronology of discoveries, but its development is better understood as a recurring process through which scientific possibility becomes durable clinical practice. This narrative review examines 130 years of nuclear medicine innovation using a conceptual framework in which transformation occurs when scientific possibility, clinical unmet need, an operational platform and a legitimising ecosystem converge. Fourteen innovation clusters are examined as translational episodes rather than isolated inventions. Across these cases, innovations became clinically transformative only when infrastructure, workflow, workforce capability, evidence, regulation, reimbursement and professional legitimacy evolved together. The analysis also shows that major technologies reorganised practice, redistributed professional roles and created new platforms from which later innovations emerge. Nuclear medicine's history reveals an innovation logic that is cumulative rather than episodic; science becomes service when discovery, infrastructure, workforce, evidence and legitimacy converge. This framework provides a basis for understanding both past transformation and the conditions under which future innovations are most likely to reshape nuclear medicine.