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      The use of PET/CT in prostate cancer.

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          Abstract

          Positron emission tomography/computed tomography (PET/CT) has recently emerged as a promising diagnostic imaging platform for prostate cancer. Several radiolabelled tracers have demonstrated efficacy for cancer detection in various clinical settings. In this review, we aim to illustrate the diverse use of PET/CT with different tracers for the detection of prostate cancer.

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          The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis.

          A. Hövels, R A M Heesakkers, E. M. Adang … (2008)
          To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of lymph node metastases in prostate cancer. After a comprehensive literature search, studies were included that allowed construction of contingency tables for detection of lymph node metastases using CT or MRI. In addition, a summary receiver-operating characteristic (ROC) analysis was performed. A total of 24 studies were included. For CT, pooled sensitivity was 0.42 (0.26-0.56 95% CI) and pooled specificity was 0.82 (0.8-0.83 95% CI). For MRI, the pooled sensitivity was 0.39 (0.22-0.56 95% CI) and pooled specificity was 0.82 (0.79-0.83 95% CI). The differences in performance of CT and MRI were not statistically significant. CT and MRI demonstrate an equally poor performance in the detection of lymph node metastases from prostate cancer. Reliance on either CT or MRI will misrepresent the patient's true status regarding nodal metastases, and thus misdirect the therapeutic strategies offered to the patient.
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            Current use of PSMA-PET in prostate cancer management.

            Tobias Maurer, Matthias Eiber, Markus Schwaiger … (2016)
            Currently, the findings of imaging procedures used for detection or staging of prostate cancer depend on morphology of lymph nodes or bone metabolism and do not always meet diagnostic needs. Prostate-specific membrane antigen (PSMA), a transmembrane protein that has considerable overexpression on most prostate cancer cells, has gained increasing interest as a target molecule for imaging. To date, several small compounds for labelling PSMA have been developed and are currently being investigated as imaging probes for PET with the (68)Ga-labelled PSMA inhibitor Glu-NH-CO-NH-Lys(Ahx)-HBED-CC being the most widely studied agent. (68)Ga-PSMA-PET imaging in combination with multiparametric MRI (mpMRI) might provide additional molecular information on cancer localization within the prostate. In patients with primary prostate cancer of intermediate-risk to high-risk, PSMA-based imaging has been reported to improve detection of metastatic disease compared with CT or mpMRI, rendering additional cross-sectional imaging or bone scintigraphy unnecessary. Furthermore, in patients with biochemically recurrent prostate cancer, use of (68)Ga-PSMA-PET imaging has been shown to increase detection of metastatic sites, even at low serum PSA values, compared with conventional imaging or PET examination with different tracers. Thus, although current knowledge is still limited and derived mostly from retrospective series, PSMA-based imaging holds great promise to improve prostate cancer management.
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              Initial Evaluation of [(18)F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer.

              Zsolt Szabó, Esther Mena, Steven Rowe … (2015)
              Prostate-specific membrane antigen (PSMA) is a recognized target for imaging prostate cancer. Here we present initial safety, biodistribution, and radiation dosimetry results with [(18)F]DCFPyL, a second-generation fluorine-18-labeled small-molecule PSMA inhibitor, in patients with prostate cancer.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Prostate Cancer Prostatic Dis.
                Title: Prostate cancer and prostatic diseases
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1476-5608
                ISSN (Print): 1365-7852
                Publication date (Electronic): April 2018
                Volume: 21
                Issue: 1
                Affiliations
                [1 ] Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1373, Houston, TX, 77030, USA. rli4@mdanderson.org.
                [2 ] Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
                [3 ] The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
                [4 ] Department of Urology, Technical University of Munich, Munich, Germany.
                [5 ] Department of Nuclear Medicine, Technical University of Munich, Munich, Germany.
                [6 ] Department of Urology, UCSF, San Francisco, CA, USA.
                [7 ] Department of Urology, Emory University, Atlanta, GA, USA.
                [8 ] Department of Urology, Mayo Clinic, Rochester, MN, USA.
                [9 ] Department of Urology, Louisiana State University, New Orleans, LA, USA.
                [10 ] Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1373, Houston, TX, 77030, USA.
                Article
                Publisher Item ID: 10.1038/s41391-017-0007-8
                DOI: 10.1038/s41391-017-0007-8
                PubMed ID: 29230009
                SO-VID: 64b2c03a-c495-4bf0-b7a6-1d4c895121a4
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