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99mTc-EUK-(SO3)CY5-MAS3 is a dual-modality (hybrid) radiopharmaceutical and optical imaging agent designed for the intraoperative detection and surgical guidance of prostate cancer. Developed by the Netherlands Cancer Institute (NKI-AVL), the molecule consists of a PSMA-targeting Glu-urea-Lys (EUK) motif, a sulfonated Cyanine 5 (Cy5) fluorescent dye, and a mercaptoacetyltriglycine (MAS3) chelator for technetium-99m (99mTc). It specifically targets the Prostate-Specific Membrane Antigen (PSMA), also known as glutamate carboxypeptidase II, which is highly overexpressed in prostate cancer cells. The 99mTc component allows for preoperative SPECT/CT imaging and intraoperative radioguidance using a gamma probe, while the fluorescent Cy5 component enables real-time, high-resolution visualization of tumor margins and lymph node metastases during surgery. This hybrid approach aims to improve the accuracy of surgical resection and the detection of occult nodal disease.
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