Prostate-Specific Membrane Antigene PET/CT in Biochemical Recurrence
Journal Title: Nükleer Tıp Seminerleri - Year 2018, Vol 4, Issue 3
Abstract
Prostate cancer is the most common solid malignancy in men. The biochemical recurrence is defined as an increase in levels of prostate-specific antigen (PSA) after radical therapy. It is a common occurrence and occurs in about 20-30% of patients treated with radical prostatectomy and up to 60% in patients treated primary with external beam radiotherapy. Patients are therefore generally directed to a salvage radiotherapy on the prostate bed (suspicion of local recurrence) or to a systemic treatment with hormonal therapy. Conventional imaging, including computed tomography, bone scintigraphy and magnetic resonance, showed low accuracy values for restaging patients being biochemical recurrence. During the last decade, the nuclear medicine techniques such as positron emission tomography (PET), with F-18 choline, were found to be more accurate than conventional diagnostic tests for restaging patients with prostate cancer with progress in biochemical recurrence. However, the PET/computed tomography (CT) with choline showed a suboptimal sensitivity if performed in patients with early biochemical recurrence, in patients with low serum PSA (<0.2 ng/mL) after radical therapy. Recently, a new molecule has been developed that molecule that targets the prostate-specific membrane antigene (PSMA). The PSMA is a membrane enzyme that is mainly expressed in prostate cancer cells when compared with its expression in healthy prostate tissue. Preliminary studies with PSMA as a radiopharmaceutical for PET-CT imaging showed that its accuracy for the diagnosis of early disease recurrence was significantly higher than F-18 choline. Further studies conducted in larger patient populations with biochemical recurrence after radical therapy, showed excellent diagnostic power of Ga-68 PSMA PET/CT in restaging patients with biochemical recurrence of the disease even if serum PSA values very low. For the reasons explained above, the PSMA could be an excellent molecular target for the development of radiotracers for PET/CT imaging that could detect early relapse of disease.
Authors and Affiliations
Umut Elboğa
Keywords
Related Articles
- EP ID EP421372
- DOI 10.4274/nts.2018.024
- Views 92
- Downloads 0
Advances in Nuclear Cardiology: Instrumentation, Software and Radiopharmaceuticals
Progress in equipment and software technology in nuclear medicine has contributed substantially to cardiac imaging. The most notable consequences of this progress are improvement in image quality and reduction in acquisi...
Theranostics Applications in Neuroendocrine Tumors of Thorax
The term of theranostic refers to the combination of therapy and diagnostic imaging. In practise, this concept has dated back about 50 years ago, however, the most successful example of theranostic approaches has emerged...
Radioisotopes and Biomedical Applications in Nuclear Medicine
Nuclear imaging is a diagnostic medical imaging method that uses radiopharmaceuticals or radiotracers to examine the physiology and metabolism of the body. This imaging modality is the result of radiation emitted from th...
Pathological Examination of Sentinel Lymph Node Biopsy
Sentinel lymph node biopsy SLNB is a standardized method with a high accuracy rate, which is currently applied in many centers at the stage of axillary lymph node involvement of early stage, clinically node-negative brea...
The Role of Multiparametric Prostate Magnetic Resonance Imaging in Biochemical Recurrence
Biochemical recurrence (BCR) occurs frequently after prostate cancer treatment with incidence rates of approximately 20-35% at 10-year follow-up. Thus, detection and treatment of recurrence has become an important issue....