Therapy assessment of bone metastatic disease in the era of <sup>223</sup>radium.

Etchebehere, Elba; Brito, Ana Emilia; Rezaee, Alireza; Langsteger, Werner; Beheshti, Mohsen · Eur J Nucl Med Mol Imaging · 2017

review · Level V

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Abstract

Defining an optimal imaging modality for assessment of therapy and the best time of evaluation are pivotal for ideal patient's management. <sup>223</sup>Ra (Xofigo®, formerly Alpharadin) has been approved by the FDA and European Medicines Agency for treatment of metastatic castration-resistant prostate cancer with painful osseous involvement. PET/CT imaging using various radiotracers such as <sup>18</sup>F-FDG, <sup>18</sup>F-FCH, <sup>68</sup>Ga-PSMA and <sup>18</sup>F-NaF have been investigated to mitigate the limitations of conventional imaging modalities. Diagnostic radiotracers that have properties similar to a therapeutic radiotracer will precisely assess of the possibility and efficacy of a treatment; this is the theranostic concept. An example of a diagnostic test employed for selecting targeted therapy is the combined use of <sup>18</sup>F-fluoride PET/CT for evaluation of possible therapy with <sup>223</sup>Ra. This review examines the most recent publications related to this topic.

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