The Role of PET and SPECT Imaging in Prostate Cancer Targeted Alpha Therapy: When and How?

Author:

Frantellizzi Viviana1ORCID,Ricci Maria2ORCID,Cimini Andrea3ORCID,Filippi Luca4ORCID,Conte Miriam1,De Feo Maria Silvia1,De Vincentis Giuseppe1ORCID

Affiliation:

1. Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy

2. Nuclear Medicine Unit, Cardarelli Hospital, 86100 Campobasso, Italy

3. Nuclear Medicine Unit, St. Salvatore Hospital, 67100 L’Aquila, Italy

4. Department of Nuclear Medicine, Santa Maria Goretti Hospital, 04100 Latina, Italy

Abstract

This review discusses the current state of Targeted Alpha Therapy (TAT) in prostate cancer, particularly in mCRPCT (metastatic castration-resistant prostate cancer). This review describes the widely used Radium-223 and the novel trend in the TAT field with a special focus on prostate-specific membrane antigen (PSMA)-based alpha therapy. With this in-depth discussion on the growing field of PSMA-based alpha therapy, we aim also to analyze the most useful diagnostic tools in the patient selection and in the treatment monitoring. We explored the diagnostic tools used in clinical practice and in research settings in order to clarify the imaging procedures that may support the PSMA-based TAT management, including both the patient’s selection and the therapy response monitoring, with a special focus on diagnostic PSMA-PET/CT imaging. Further multicenter trials are needed, but a better understanding of the strengths and limitations of molecular imaging in PSMA-based TAT management may help in creating an effective therapeutic algorithm for mCRPC and designing a rational approach to treatment.

Publisher

MDPI AG

Subject

Fluid Flow and Transfer Processes,Computer Science Applications,Process Chemistry and Technology,General Engineering,Instrumentation,General Materials Science

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