The literature review considers the prospects for the use of SPECT and PET imaging with 99mTc-PSMA as an innovative method for diagnosing prostate cancer.
SPECT studies with 111In-PSMA-I have further expanded the scope of modern therapeutic concepts aimed at PSMA. However, the inherent limitations associated with 111In preclude the wider clinical use of 111In-PSMA-I and T, in addition to studies confirming the concept, in small cohorts of patients.
The total body clearance of 99mTc-PSMA-I and S is relatively slow, which results in a relatively late clearance in the abdominal region. However, the accumulation of the radiopharmaceutical in previously identified areas of tumor lesions steadily grows over time due to the prolonged presence of an intact indicator in the blood and its internalization into tumor cells with high PSMA expression. In a delayed period, an excellent lesion-background ratio is obtained due to the synergistic effect of stable uptake of 99mTc-PSMA-I and S in tumor tissue and the continuation of the clearance of background activity.
Several alternative therapeutic approaches have been implemented to provide a universal molecular platform for labeling with diagnostic (123I / 124I, 68Ga) and therapeutic radionuclide (131I, 177Lu). Baseline data on endoradiotherapeutic use of 131I-MIP-1095, 177Lu-DKFZ-617 and 177Lu-PSMA-I and T in patients with metastatic prostate cancer demonstrate the prospects of molecular and morphological treatment.
Thus, the aim of this work was to adapt the general concept of the indicator with the requirements of 99mTc. The availability and ease of preparation of 99mTc-PSMA indicators is fully compatible with the daily clinical workflow. In this regard, a lyophilized kit for the routine manufacture of 99mTc-PSMA-I and S appears to be available and reliable, which facilitates the distribution and production of new effective radiopharmaceuticals for clinical use in urology and, in particular, nuclear medicine.
Key words: nuclear medicine, prostate cancer, single-photon emission computed tomography, prostate-specific membrane antigen.
Guidelines for Clinical Use of Cardiac Nuclear Medicine (JCS 2010)