Navigating response criteria in mCRPC: role of PSMA PET/CT and new insights

Q J Nucl Med Mol Imaging. 2025 Jun;69(2):129-136. doi: 10.23736/S1824-4785.25.03639-8.

Abstract

Metastatic castration-resistant prostate cancer (mCRPC) is an unavoidable advanced condition associated with short-term survival and poor prognosis. It is a heterogeneous disease, difficult to monitor based only on serum PSA levels. For this reason, systematic use of PSMA PET-based response criteria should be considered to assess therapy efficacy in mCRPC to improve treatment decision-making, patients' outcomes, and cost-effectiveness. Our review focuses on most common morphologic and metabolic response criteria and their application for the detection and therapy response assessment of PC patients, particularly in the setting of mCRPC, highlighting relative strengths and weaknesses, as well as potential future applications in the era of RLT.

Publication types

  • Review

MeSH terms

  • Antigens, Surface* / metabolism
  • Glutamate Carboxypeptidase II* / metabolism
  • Humans
  • Male
  • Positron Emission Tomography Computed Tomography* / methods
  • Prostatic Neoplasms, Castration-Resistant* / diagnostic imaging
  • Prostatic Neoplasms, Castration-Resistant* / metabolism
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Prostatic Neoplasms, Castration-Resistant* / therapy
  • Treatment Outcome

Substances

  • Glutamate Carboxypeptidase II
  • FOLH1 protein, human
  • Antigens, Surface