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
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- EP ID EP421372
- DOI 10.4274/nts.2018.024
- Views 104
- Downloads 0
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