Salivary Gland Toxicity of PSMA Radioligand Therapy: Relevance and Preventive Strategies

Physiologic tracer uptake is detected in SGs of 59-y-old metastatic castration-resistant prostate cancer patient on pretherapeutic ⁶⁸Ga PET/CT study (A), whereas PSMA uptake in SGs declines by up to 65% on follow-up imaging (B and C) after PRLT using ²²⁵Ac. Dynamic SG scintigraphy demonstrates regular baseline function (D); however, posttherapeutic study reveals functional impairment despite absence of clinical symptoms of xerostomia (E).