Clinical Evaluation of Ultrasound-Enhanced Radiotracer Uptake for Radioligand Therapy in Metastatic Prostate Cancer

BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) may noninvasively enhance intratumoral delivery of radiopharmaceuticals, but clinical data are scarce. The authors prospectively evaluated whether adding LIPUS to prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) improves uptake and outcomes in metastatic prostate cancer while maintaining safety. METHODS: ≥20%) or low enhancement. Prostate-specific antigen (PSA) response, progression-free survival (PFS), and toxicity were recorded. RESULTS: Lu-PSMA toxicities; no Grade ≥3 LIPUS-related events occurred. CONCLUSIONS: US-enhanced RLT appears safe and can increase intratumoral radiotracer uptake, translating into improved biochemical control and PFS in metastatic prostate cancer.