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Technetium Tc-99m PSMA I&S is a diagnostic radiopharmaceutical designed for the targeted imaging and intraoperative localization of prostate cancer lesions. The "I&S" designation stands for "Imaging and Surgery," highlighting its dual clinical utility: pre-operative staging via Single-Photon Emission Computed Tomography (SPECT) and intraoperative radioguided surgery (RGS) using a gamma probe. The molecule consists of a small-molecule urea-based ligand that high-affinity binds to the **prostate-specific membrane antigen (PSMA)**, conjugated via a linker to a mercaptoacetyltriglycine (MAS3) chelator for stable complexation with technetium-99m. PSMA is significantly overexpressed in nearly all prostate cancer cells, particularly in high-grade and metastatic disease. By enabling surgeons to detect occult lymph node metastases and residual tumor tissue in real-time, it aims to improve the precision of salvage lymphadenectomy and radical prostatectomy.
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