Feasibility of positronium lifetime imaging to assess tumor hypoxia in prostate cancer

Ascertain whether positronium lifetime imaging using clinical PET systems can noninvasively investigate tumor hypoxia in prostate cancer lesions, particularly in the context of PSMA-targeted diagnostics and therapy.

Background

The review highlights the growing use of 68Ga-PSMA PET for patient selection and response monitoring in prostate cancer theranostics, noting that approximately 30% of patients do not respond sufficiently to 177Lu-PSMA therapy. Tumor hypoxia is suggested as a potential contributor to aggressive disease phenotypes and treatment resistance.

Given positronium’s sensitivity to oxygen concentration, positronium lifetime imaging could, in principle, interrogate hypoxia. However, the paper explicitly notes that it is unclear whether this approach can probe hypoxia in prostate cancer, motivating focused clinical feasibility studies.