{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:02:02Z","timestamp":1777006922501,"version":"3.51.4"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lutetium-177 (177Lu)-PSMA radioligand therapy (RLT) is established for metastatic castration-resistant prostate cancer (mCRPC), but radiologic monitoring during the treatment lacks standardization. While interim PSMA PET\/CT offers accuracy, post-treatment 177Lu-PSMA SPECT\/CT provides practical advantages for early response assessment. This systematic review and meta-analysis evaluates the prognostic value of interim post-treatment SPECT\/CT parameters on survival outcomes in mCRPC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines and PICO framework, PubMed\/MEDLINE, Scopus, and Google Scholar were searched up to December 2025 for studies on mCRPC patients receiving 177Lu-PSMA RLT with early post-treatment SPECT\/CT. Inclusion required cohort designs reporting hazard ratios (HRs) for overall survival (OS) and PSA-progression-free survival (PSA-PFS). Data extraction included study characteristics, imaging protocols, and outcomes. Quality was assessed using the Oxford CEBM tool. Random-effects meta-analysis pooled HRs; heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) and publication bias (funnel plots, Egger\u2019s test, trim-and-fill) were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven studies (648 patients) were included. Pooled HRs showed emerging new lesions associated with worse OS (HR\u202f=\u202f2.78, 95% CI: 1.91\u20134.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and PSA-PFS (HR\u202f=\u202f4.72, 95% CI: 1.57\u201314.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006). Total tumor volume (TTV) increases predicted inferior OS (HR\u202f=\u202f1.80, 95% CI: 1.29\u20132.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and PSA-PFS (HR\u202f=\u202f2.86, 95% CI: 2.12\u20133.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). SUVmean and SUVmax reductions were non-significant. Heterogeneity was low-moderate and publication bias had minimal impact post-adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interim 177Lu-PSMA SPECT\/CT offers prognostic insights, with new lesions and TTV increases signaling poor outcomes. Standardization and prospective validation are needed to integrate it into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1808563","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:29:54Z","timestamp":1777004994000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of interim post-treatment SPECT\/CT following lutetium-177 (177Lu)-PSMA therapy in patients with metastatic castration-resistant prostate cancer: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Amirreza","family":"Shamshirgaran","sequence":"first","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Hadi","family":"Samadi","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Aboutalebi","sequence":"additional","affiliation":[{"name":"School of Medicine, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Setareh","family":"Zahedian","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pegah","family":"Sahafi","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Saeed","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Candiolo Cancer Institute, FPO-IRCCS","place":["Turin, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Treglia","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale","place":["Bellinzona and Lugano, Switzerland"]},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI)","place":["Lugano, Switzerland"]},{"name":"Faculty of Biology and Medicine, University of Lausanne (UNIL)","place":["Lausanne, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atena","family":"Aghaee","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emran","family":"Askari","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Research Center, Mashhad University of Medical Sciences (MUMS)","place":["Mashhad, Iran"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"S1627","DOI":"10.1016\/j.annonc.2025.09.101","article-title":"LBA6 phase III trial of [177Lu]Lu-PSMA-617 combined with ADT + ARPI in patients with PSMA-positive metastatic hormone-sensitive prostate cancer 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