Researchers reported data supporting a blood-based ctDNA profiling approach to better select patients for metastatic castration-resistant prostate cancer radiopharmaceutical therapy with radium-223 (^223Ra). The study, published in the July issue of The Journal of Nuclear Medicine, suggests ctDNA can identify which patients are more likely to benefit from treatment. In the proposed workflow, circulating tumor DNA profiling flags candidates for ^223Ra rather than relying only on conventional clinical and imaging factors. The goal is improved matching for a therapy where patient heterogeneity can drive wide outcomes. The report adds to the growing push toward liquid-biopsy decision support in nuclear medicine—where selection and sequencing can be as important as the radiopharmaceutical itself.