Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives

SIMPLE SUMMARY: The huge armamentarium of currently available theragnostic modalities allows a novel approach to prostate cancer from imaging to therapy. Clinical examination is the starting-point, then radiology and nuclear medicine are often needed to define the illness grading to set up the best therapeutic strategy. Prostate cancer care horizons are opening with the aid of nuclear medicine, which takes advantage of the technological ascendancy of prostate-specific membrane antigen-based imaging and therapy and is currently evolving with machine-learning approaches. We have focused our review on the current state, on the advancements, and on the future prospects of nuclear medicine modalities that could change prostate cancer’s standard of care. ABSTRACT: Prostate cancer is the most frequent epithelial neoplasia after skin cancer in men starting from 50 years and prostate-specific antigen (PSA) dosage can be used as an early screening tool. Prostate cancer imaging includes several radiological modalities, ranging from ultrasonography, computed tomography (CT), and magnetic resonance to nuclear medicine hybrid techniques such as single-photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. Innovation in radiopharmaceutical compounds has introduced specific tracers with diagnostic and therapeutic indications, opening the horizons to targeted and very effective clinical care for patients with prostate cancer. The aim of the present review is to illustrate the current knowledge and future perspectives of nuclear medicine, including stand-alone diagnostic techniques and theragnostic approaches, in the clinical management of patients with prostate cancer from initial staging to advanced disease.