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Clinical implementation of RECIP 1.0
Ishita Sen1, Dharmender Malik1, Parul Thakral1
1Department of Nuclear Medicine, Fortis Memorial Research Institute, Gurgaon -122002 Haryana, India.
Seminars in Nuclear Medicine
|January 10, 2026
Summary
The Response Evaluation Criteria in PSMA PET/CT (RECIP 1.0) offers a new standard for assessing prostate cancer treatment response using PSMA PET imaging. This framework improves upon traditional methods by incorporating tumor volume and new lesions for better patient outcome prediction.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Prostate cancer poses a significant global health challenge.
- Advanced prostate cancer treatment has been revolutionized by PSMA-targeted PET imaging and radioligand therapy.
- Existing response assessment tools (PSA kinetics, CT, bone scans, PCWG3, RECIST) have limitations including PSA flare, inability to assess bone-only disease, and low sensitivity for early metastatic changes.
Purpose of the Study:
- To introduce and validate the Response Evaluation Criteria in PSMA PET/CT (RECIP 1.0) as a standardized framework for evaluating treatment response in advanced prostate cancer.
- To address the limitations of traditional assessment methods by leveraging PSMA PET imaging.
- To provide a robust tool for clinical trials and routine practice.
Main Methods:
- Development of RECIP 1.0, an evidence-based framework incorporating changes in PSMA-positive total tumor volume and the appearance of new lesions.
- Stratification of treatment response into complete response, partial response, stable disease, or progressive disease.
- Evaluation of the prognostic value of RECIP 1.0 for overall and progression-free survival.
- Assessment of a visual RECIP method for routine clinical practice feasibility and concordance with quantitative segmentation.
Main Results:
- RECIP 1.0 demonstrates strong prognostic value for overall and progression-free survival in advanced prostate cancer.
- The framework enables standardized reporting crucial for clinical trials.
- A visual RECIP method shows excellent concordance with quantitative software-based segmentation, enhancing feasibility.
- Emerging AI tools show promise in streamlining RECIP implementation.
Conclusions:
- RECIP 1.0 provides a robust and clinically meaningful framework for assessing treatment response in PSMA-targeted theranostics for prostate cancer.
- This standardized approach improves upon traditional methods, offering better prognostic insights.
- Further development, including AI integration, will enhance the widespread adoption and efficiency of RECIP 1.0 in clinical practice.
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