{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:00:55Z","timestamp":1791568855577,"version":"4.3.4"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Recurrent brain tumors\u2014including high-grade gliomas, brain metastases, and aggressive meningiomas\u2014continue to carry a poor prognosis, with high mortality despite therapeutic advances. The aim of this narrative review is to summarize and critically discuss the current evidence on the role of intra-arterial radioligand therapy (RLT) in the treatment of recurrent brain tumors. RLT, a targeted form of radionuclide therapy, has gained increasing attention for its potential theranostic applications in neuro-oncology. A literature search was conducted using PubMed and Scopus, including clinical studies evaluating intra-arterial radioligand delivery in central nervous system tumors. Recent research has explored intra-arterial administration of radioligands targeting somatostatin receptors and prostate-specific membrane antigen (PSMA). Somatostatin receptors are overexpressed in meningiomas, while PSMA is highly expressed in the neovasculature of glioblastomas and brain metastases; both targets can be addressed using lutetium-177 (177Lu)- or actinium-225 (225Ac)-labeled radiopharmaceuticals, traditionally delivered intravenously. Available evidence indicates that the intra-arterial route achieves markedly higher radionuclide uptake on 68Ga-PSMA-11 and 68Ga-DOTATOC PET, as well as increased absorbed doses in dosimetric models. Dosimetric analyses consistently show greater tracer accumulation compared with intravenous administration, without evidence of significant peri-procedural toxicity. Uptake in healthy brain tissue is minimal, and no relevant differences have been reported in liver or salivary gland accumulation between intra-arterial and intravenous RLT. Although based on heterogeneous and limited data, intra-arterial RLT appears to be a promising therapeutic strategy for recurrent brain tumors. Future research should focus on improving radioligand delivery beyond the blood\u2013brain barrier and enhancing effective tumor targeting.<\/jats:p>","DOI":"10.3390\/diagnostics16020341","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T11:11:17Z","timestamp":1768993877000},"page":"341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intra-Arterial Radioligand Therapy in Brain Cancer: Bridging Nuclear Medicine and Interventional Neuroradiology"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-755X","authenticated-orcid":false,"given":"Federico","family":"Sabuzi","sequence":"first","affiliation":[{"name":"Department of Biomedicine and Prevention, University Hospital of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4423-5496","authenticated-orcid":false,"given":"Luca","family":"Filippi","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University Hospital of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3374-7847","authenticated-orcid":false,"given":"Mariafrancesca","family":"Trulli","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University Hospital of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6776-2737","authenticated-orcid":false,"given":"Fabio","family":"Domenici","sequence":"additional","affiliation":[{"name":"Department of Chemical Science and Technologies, University of Rome \u201cTor Vergata\u201d, Via della Ricerca Scientifica 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Garaci","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University Hospital of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-7594","authenticated-orcid":false,"given":"Valerio","family":"Da Ros","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University Hospital of Rome \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1227\/01.NEU.0000170980.47582.A5","article-title":"Diagnosis and Treatment of Atypical and Anaplastic Meningiomas: A Review","volume":"57","author":"Modha","year":"2005","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chen, X., Cui, Y., and Zou, L. 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