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Technetium-99m HYNIC-PSMA (also known as TLX599-CDx or technetium Tc-99m iPSMA) is a technetium-99m-labeled radiopharmaceutical designed for the diagnostic imaging of prostate cancer using single-photon emission computed tomography (SPECT/CT). It consists of a small-molecule PSMA-targeting ligand—specifically a Lys(Nal)-urea-Glu motif—conjugated to a hydrazinonicotinamide (HYNIC) chelator, typically utilizing ethylenediamine-N,N'-diacetic acid (EDDA) as a co-ligand. The tracer binds with high affinity to the extracellular domain of the prostate-specific membrane antigen (PSMA), which is highly overexpressed in prostate cancer cells. Developed as a cost-effective and widely accessible alternative to PET-based PSMA imaging (such as Ga-68 PSMA-11), it leverages the global infrastructure of SPECT cameras and technetium-99m generators. It is being evaluated in the global NOBLE (NOn-invasive Bridging of gLobal rEsource) registry for applications in primary staging, biochemical recurrence, and metastatic disease.
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