{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:02:11Z","timestamp":1774587731913,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Radioligand therapy (RLT) targeting PSMA (prostate-specific membrane antigen) has transformed the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, bone marrow depletion remains a common side effect, particularly in patients with extensive bone metastases or prior myelotoxic therapies. This study evaluated [<jats:sup>99m<\/jats:sup>Tc]Tc-antigranulocyte scintigraphy to assess bone marrow reserve to guide myelotoxic treatment decisions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Ten mCRPC patients with extensive osseous tumor load on [<jats:sup>18<\/jats:sup>F]F-PSMA PET\/CT underwent [<jats:sup>99m<\/jats:sup>Tc]Tc-antigranulocyte scintigraphy to assess bone marrow reserve and RLT eligibility (interval: 26.6\u2009\u00b1\u200918.5 days). Visual comparison of both modalities evaluated tumor-bone marrow overlap. Patients without significant co-localization received RLT ([<jats:sup>177<\/jats:sup>Lu]Lu-PSMA or [<jats:sup>225<\/jats:sup>Ac]Ac-PSMA) with laboratory monitoring before and between the cycles.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>No significant co-localization between viable bone marrow and PSMA-positive metastases was observed in 9\/10 (90.0%) patients. Two other patients were excluded from RLT due to contraindications. Of the remaining seven patients, 2\/7 (28.6%) underwent subsequent [<jats:sup>177<\/jats:sup>Lu]Lu-PSMA therapy, 2\/7 (28.6%) [<jats:sup>225<\/jats:sup>Ac]Ac-PSMA therapy and 2\/7 (28.6%) [<jats:sup>225<\/jats:sup>Ac]Ac-[<jats:sup>177<\/jats:sup>Lu]Lu-PSMA therapy. 1\/7 (14.3%) received a single cycle of [<jats:sup>177<\/jats:sup>Lu]Lu-PSMA, which was then followed by [<jats:sup>225<\/jats:sup>Ac]Ac-PSMA therapy. Follow-up laboratory results showed no significant changes from baseline (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>[<jats:sup>99m<\/jats:sup>Tc]Tc-antigranulocyte scintigraphy may support the assessment of bone marrow reserve in patients with extensive bone metastases. Spatial mismatch was associated with no significant myelotoxicity, whereas high congruence may increase the risk. No fixed thresholds currently exist; thus, this method should be regarded as a supplementary tool in complex cases and future studies are needed to define the critical bone marrow volume.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-025-07319-7","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T20:01:23Z","timestamp":1746475283000},"page":"4446-4455","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["[99mTc]Tc-antigranulocyte scintigraphy for prediction of bone marrow reserve prior to radioligand therapy in patients with metastatic castration resistant prostate cancer"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3175-952X","authenticated-orcid":false,"given":"Sophie Carina","family":"Kunte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Delker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Holzgreve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias J.","family":"Zacherl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Scheifele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozefina","family":"Casuscelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz Josef","family":"Gildehaus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Unterrainer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harun","family":"Ilhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena M.","family":"Unterrainer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"7319_CR1","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.cpet.2021.03.004","volume":"16","author":"R Seifert","year":"2021","unstructured":"Seifert R, Alberts IL, Afshar-Oromieh A, Rahbar K. Prostate Cancer theranostics: PSMA targeted therapy. PET Clin. 2021;16:391\u20136. https:\/\/doi.org\/10.1016\/j.cpet.2021.03.004.","journal-title":"PET Clin"},{"key":"7319_CR2","doi-asserted-by":"publisher","first-page":"85","DOI":"10.2967\/jnumed.116.183194","volume":"58","author":"K Rahbar","year":"2017","unstructured":"Rahbar K, Ahmadzadehfar H, Kratochwil C, Haberkorn U, Sch\u00e4fers M, Essler M, et al. German multicenter study investigating 177Lu-PSMA-617 radioligand therapy in advanced prostate Cancer patients. J Nucl Med. 2017;58:85\u201390. https:\/\/doi.org\/10.2967\/jnumed.116.183194.","journal-title":"J Nucl Med"},{"key":"7319_CR3","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1056\/NEJMoa2107322","volume":"385","author":"O Sartor","year":"2021","unstructured":"Sartor O, de Bono J, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177-PSMA-617 for metastatic Castration-Resistant prostate Cancer. 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[The association of docetaxel side effects and introduction of subsequent Cabazitaxel for Castration-Resistant prostate cancer: A clinical study]. Hinyokika Kiyo. 2024;70:141\u20137. https:\/\/doi.org\/10.14989\/ActaUrolJap_70_6_141.","journal-title":"Hinyokika Kiyo"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-025-07319-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-025-07319-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-025-07319-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T08:36:43Z","timestamp":1759394203000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-025-07319-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["7319"],"URL":"https:\/\/doi.org\/10.1007\/s00259-025-07319-7","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]},"assertion":[{"value":"13 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This analysis was performed in compliance with the principles of the Declaration of Helsinki and was approved by the institutional ethics board of the LMU Munich (IRB 24\u20130982).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MJZ: speaker honoraria from Novartis, SIRTEX and Terumo, advisory board for Boston Scientific. RAW: speaker honoraria from Novartis\/AAA and PentixaPharm, advisory board work for Novartis\/AAA and Bayer. AH reports compensation for scientific consulting by ABX advanced biochemical compounds outside the submitted work. L.M.U. reports fees from Novartis (speaker), Telix (consultant) and Astellas Pharma Inc. (speaker) outside of the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}