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AI-based tumor and organ volumetry predicts early progression after Y-90 radioembolization in liver-dominant metastatic disease.

European journal of nuclear medicine and molecular imaging·2026
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Toward a Biopsy-Free Diagnosis of Prostate Cancer: Potential of Combined <sup>18</sup>F-Flotufolastat PSMA PET and mpMRI.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine·2026
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Impact of different PSMA PET-based eligibility criteria on outcome of [<sup>177</sup>Lu]Lu-PSMA radioligand therapy using [<sup>18</sup>F]rhPSMA-7/[<sup>18</sup>F]rhPSMA-7.3 (Flotufolastat).

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Liquid Biopsy Biomarkers in Patients With Metastatic Castration-Resistant Prostate Cancer Receiving Prostate-Specific Membrane Antigen Radioligand Therapy: Protocol for a Prospective, Longitudinal Multicenter Observational Study.

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Pattern of Failure in Patients with Biochemical Recurrence After PSMA Radioguided Surgery.

Lilit Schweiger1,2, Tobias Maurer3,4, Ricarda Simon4

  • 1Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany; lilit.schweiger@mri.tum.de.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|September 26, 2024
PubMed
Summary

Prostate-specific membrane antigen (PSMA)-targeted radioguided surgery (RGS) can lead to recurrence. PSMA-ligand PET imaging in patients after PSMA RGS shows over half experience locoregional recurrence, suggesting potential for further local treatment.

Keywords:
biochemical recurrenceprostate cancerprostate‐specific membrane antigenradioguided surgery

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiology

Background:

  • Prostate-specific membrane antigen (PSMA)-targeted radioguided surgery (RGS) is an emerging treatment for early recurrent prostate cancer.
  • The pattern of disease recurrence after PSMA RGS, specifically locoregional versus systemic failure, is not well understood.

Purpose of the Study:

  • To evaluate the pattern of disease recurrence in patients who experienced biochemical relapse after PSMA RGS.
  • To assess the utility of PSMA-ligand PET in detecting and localizing recurrent prostate cancer post-PSMA RGS.

Main Methods:

  • Retrospective analysis of 100 patients with biochemical recurrence after PSMA RGS who underwent PSMA-ligand PET.
  • Lesions were classified using the molecular imaging TNM system and stratified by PSA levels and Gleason grade group.
  • Detection rates and lesion localization were analyzed, comparing findings before and after PSMA RGS.

Main Results:

  • 91% of patients showed PSMA-ligand-positive findings on PET scans.
  • Over half of patients (53%) presented with locoregional recurrence (local or pelvic lymph node metastases).
  • Extrapelvic lymph node, bone, and visceral metastases were observed in 22%, 16%, and 9% of patients, respectively. Higher Gleason grade correlated with increased distant metastases.

Conclusions:

  • PSMA-ligand PET is effective for detecting and localizing recurrent prostate cancer after PSMA RGS.
  • The high rate of locoregional recurrence suggests that a significant proportion of patients may be candidates for repeat local therapies.
  • Findings support the role of PSMA-ligand PET in guiding treatment decisions for recurrent prostate cancer post-PSMA RGS.