Peer-reviewedCC BY 4.0Journal of Nuclear Medicine3 Nov 2026

The Global Theranostics Access Gap: Real-World Disparities in PSMA PET/CT and 177Lu-PSMA Therapy Between Centers in Brazil and Europe

Juliano J. Cerci¹
Stefano Fanti²
Ken Herrmann³
Denise Ferreira Rodrigues¹
Pedro Henrique Furst Leite¹
Margaret Masukawa¹
Marcelo Moreira da Silva⁴
Wolfgang P. Fendler³
Adriano Goncalves e Silva^1,5
Elise Nara Sanfelice^1,6
Walter Ayelet³
Fabio Ghetti²

3 more authors

Andrea Bascioni²
Enrique E. Estrado Lobato⁷
Diana Paez⁷

7 affiliations

¹Instituto Teranóstico Brasil, Curitiba, Brazil
²IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
³Department of Nuclear Medicine, West German Cancer Center, DKTK and NCT Site, University Hospital Essen, Essen, Germany
⁴Department of Nuclear Medicine, IMEB–Institute of Nuclear Medicine of Brasília, Brasília, Brazil
⁵Instituto do Cancer e Transplante, Curitiba, Brazil
⁶CIONC, Curitiba, Brazil; and
⁷Division of Human Health, International Atomic Energy Agency, Vienna, Austria

Abstract

Real-world disparities in access to PSMA-targeted theranostics are poorly characterized. We compared waiting times for PSMA PET/CT and 177Lu-PSMA therapy between centers in Brazil and Europe. Methods: This retrospective multicenter study included 91 patients (50 from Brazil, 41 from Europe) treated with 177Lu-PSMA. Outcomes were days from request to PSMA PET/CT completion (diagnostic access) and days from request to first therapy dose (therapeutic access). Groups were compared using the Mann–Whitney U test. Results: Diagnostic access was similar between Brazil (median, 17.5 d; interquartile range [IQR], 9–34 d) and Europe (median, 19 d; IQR, 14–23 d; P = 0.39). Therapeutic access was significantly delayed in Brazil (median, 59 d; IQR, 54.5–91) compared with Europe (median, 21 d; IQR, 17–31 d; P < 0.01), representing a 2.8-fold longer wait. Conclusion: Despite comparable access to PSMA PET/CT, initiation of 177Lu-PSMA therapy is nearly 3 times slower in Brazil than in Europe. Closing the therapeutic access gap requires targeted investments in radiopharmaceutical supply chains and regulatory efficiency.

Socioeconomic disparities in access to care and healthcare expenditures among U.S. adults: evidence from the Medical Expenditure Panel Survey, 2018–2022
Annals of medicine and surgery (2012)17 Sep 2026Peer-reviewedCC BYFull textGeneral medicineEurope PMC
The effect of regional disparities in access to rehabilitation services on mortality among stroke patients : A Korean nationwide population-based retrospective cohort study
Dong-Yup Yoo, Chang-Yoon Baek, Jung-Kyu Choi
Medicine23 Oct 2026Peer-reviewedCC BYFull textGeneral medicineEurope PMC
Geographic and Sociodemographic Disparities in Pediatric Mental Health Care Need and Access
Yiting Chen, Mengjie Lu, Yunyu Xiao +3
JAMA Network Open30 Sep 2026Peer-reviewedCC BY 4.0General medicineCrossref
Sex Disparities in Hepatitis C Treatment Initiation: Role of Universal Access to DAA in France ( ANRS FANTASIO 2)
Fabienne Marcellin, Clémence Ramier, Cécile Brouard +10
Liver International18 Sep 2026Peer-reviewedLicence not statedFull textNeuroscience Epidemiology & public healthHAL
Porphyrin-Based Compounds in Medicine: From Photodynamic Therapy to Theranostics
Urszula Rodzoń-Wańczura, David Aebisher, Tamil Selvan Ramesh +3
Molecules (Basel, Switzerland)1 Oct 2026Peer-reviewedCC BYFull textGeneral medicineEurope PMCCrossref

Cite

BibTeX RIS

BibTeX

@article{cerci2026global,
  title = {{The Global Theranostics Access Gap: Real-World Disparities in PSMA PET/CT and 177Lu-PSMA Therapy Between Centers in Brazil and Europe}},
  author = {Juliano J. Cerci and Stefano Fanti and Ken Herrmann and Denise Ferreira Rodrigues and Pedro Henrique Furst Leite and Margaret Masukawa and Marcelo Moreira da Silva and Wolfgang P. Fendler and Adriano Goncalves e Silva and Elise Nara Sanfelice and Walter Ayelet and Fabio Ghetti and Andrea Bascioni and Enrique E. Estrado Lobato and Diana Paez},
  journal = {Journal of Nuclear Medicine},
  year = {2026},
  month = nov,
  doi = {10.2967/jnumed.126.273029},
  url = {https://doi.org/10.2967/jnumed.126.273029},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - The Global Theranostics Access Gap: Real-World Disparities in PSMA PET/CT and 177Lu-PSMA Therapy Between Centers in Brazil and Europe
AU  - Juliano J. Cerci
AU  - Stefano Fanti
AU  - Ken Herrmann
AU  - Denise Ferreira Rodrigues
AU  - Pedro Henrique Furst Leite
AU  - Margaret Masukawa
AU  - Marcelo Moreira da Silva
AU  - Wolfgang P. Fendler
AU  - Adriano Goncalves e Silva
AU  - Elise Nara Sanfelice
AU  - Walter Ayelet
AU  - Fabio Ghetti
AU  - Andrea Bascioni
AU  - Enrique E. Estrado Lobato
AU  - Diana Paez
PY  - 2026
DA  - 2026/11/03
JO  - Journal of Nuclear Medicine
DO  - 10.2967/jnumed.126.273029
UR  - https://doi.org/10.2967/jnumed.126.273029
AB  - Real-world disparities in access to PSMA-targeted theranostics are poorly characterized. We compared waiting times for PSMA PET/CT and 177Lu-PSMA therapy between centers in Brazil and Europe. Methods: This retrospective multicenter study included 91 patients (50 from Brazil, 41 from Europe) treated with 177Lu-PSMA. Outcomes were days from request to PSMA PET/CT completion (diagnostic access) and days from request to first therapy dose (therapeutic access). Groups were compared using the Mann–Whitney U test. Results: Diagnostic access was similar between Brazil (median, 17.5 d; interquartile range [IQR], 9–34 d) and Europe (median, 19 d; IQR, 14–23 d; P = 0.39). Therapeutic access was significantly delayed in Brazil (median, 59 d; IQR, 54.5–91) compared with Europe (median, 21 d; IQR, 17–31 d; P < 0.01), representing a 2.8-fold longer wait. Conclusion: Despite comparable access to PSMA PET/CT, initiation of 177Lu-PSMA therapy is nearly 3 times slower in Brazil than in Europe. Closing the therapeutic access gap requires targeted investments in radiopharmaceutical supply chains and regulatory efficiency.
SN  - 0161-5505
SN  - 1535-5667
ER  -

Abstract

Related

Cite