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Tayara O, Poletajew S, Malewski W, Kunikowska J, Pełka K, Kryst P, Nyk Ł. Prostate-Specific Membrane Antigen Expression in Patients with Primary Prostate Cancer: Diagnostic and Prognostic Value in Positron Emission Tomography-Prostate-Specific Membrane Antigen. Curr Oncol 2024; 31:4165-4177. [PMID: 39195294 PMCID: PMC11352643 DOI: 10.3390/curroncol31080311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/29/2024] Open
Abstract
Prostate cancer represents a significant public health challenge, with its management requiring precise diagnostic and prognostic tools. Prostate-specific membrane antigen (PSMA), a cell surface enzyme overexpressed in prostate cancer cells, has emerged as a pivotal biomarker. PSMA's ability to increase the sensitivity of PET imaging has revolutionized its application in the clinical management of prostate cancer. The advancements in PET-PSMA imaging technologies and methodologies, including the development of PSMA-targeted radiotracers and optimized imaging protocols, led to diagnostic accuracy and clinical utility across different stages of prostate cancer. This highlights its superiority in staging and its comparative effectiveness against conventional imaging modalities. This paper analyzes the impact of PET-PSMA on prostate cancer management, discussing the existing challenges and suggesting future research directions. The integration of recent studies and reviews underscores the evolving understanding of PET-PSMA imaging, marking its significant but still expanding role in clinical practice. This comprehensive review serves as a crucial resource for clinicians and researchers involved in the multifaceted domains of prostate cancer diagnosis, treatment, and management.
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Affiliation(s)
- Omar Tayara
- Second Department of Urology, Centre of Postgraduate Medical Education, 02-511 Warsaw, Poland; (S.P.); (W.M.); (P.K.); (Ł.N.)
| | - Sławomir Poletajew
- Second Department of Urology, Centre of Postgraduate Medical Education, 02-511 Warsaw, Poland; (S.P.); (W.M.); (P.K.); (Ł.N.)
| | - Wojciech Malewski
- Second Department of Urology, Centre of Postgraduate Medical Education, 02-511 Warsaw, Poland; (S.P.); (W.M.); (P.K.); (Ł.N.)
| | - Jolanta Kunikowska
- Department of Nuclear Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.K.); (K.P.)
| | - Kacper Pełka
- Department of Nuclear Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.K.); (K.P.)
- Department of Methodology Laboratory, Centre for Preclinical Research, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Kryst
- Second Department of Urology, Centre of Postgraduate Medical Education, 02-511 Warsaw, Poland; (S.P.); (W.M.); (P.K.); (Ł.N.)
| | - Łukasz Nyk
- Second Department of Urology, Centre of Postgraduate Medical Education, 02-511 Warsaw, Poland; (S.P.); (W.M.); (P.K.); (Ł.N.)
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Privé BM, Israël B, Janssen MJR, van der Leest MMG, de Rooij M, van Ipenburg JA, Jonker M, Peters SMB, de Groot M, Zámecnik P, Hoepping A, Bomers JG, Gotthardt M, Sedelaar JPM, Barentsz JO, van Oort IM, Nagarajah J. Multiparametric MRI and 18F-PSMA-1007 PET/CT for the Detection of Clinically Significant Prostate Cancer. Radiology 2024; 311:e231879. [PMID: 38771185 DOI: 10.1148/radiol.231879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Multiparametric MRI (mpMRI) is effective for detecting prostate cancer (PCa); however, there is a high rate of equivocal Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions and false-positive findings. Purpose To investigate whether fluorine 18 (18F) prostate-specific membrane antigen (PSMA) 1007 PET/CT after mpMRI can help detect localized clinically significant PCa (csPCa), particularly for equivocal PI-RADS 3 lesions. Materials and Methods This prospective study included participants with elevated prostate-specific antigen (PSA) levels referred for prostate mpMRI between September 2020 and February 2022. 18F-PSMA-1007 PET/CT was performed within 30 days of mpMRI and before biopsy. PI-RADS category and level of suspicion (LOS) were assessed. PI-RADS 3 or higher lesions at mpMRI and/or LOS 3 or higher lesions at 18F-PSMA-1007 PET/CT underwent targeted biopsies. PI-RADS 2 or lower and LOS 2 or lower lesions were considered nonsuspicious and were monitored during a 1-year follow-up by means of PSA testing. Diagnostic accuracy was assessed, with histologic examination serving as the reference standard. International Society of Urological Pathology (ISUP) grade 2 or higher was considered csPCa. Results Seventy-five participants (median age, 67 years [range, 52-77 years]) were assessed, with PI-RADS 1 or 2, PI-RADS 3, and PI-RADS 4 or 5 groups each including 25 participants. A total of 102 lesions were identified, of which 80 were PI-RADS 3 or higher and/or LOS 3 or higher and therefore underwent targeted biopsy. The per-participant sensitivity for the detection of csPCa was 95% and 91% for mpMRI and 18F-PSMA-1007 PET/CT, respectively, with respective specificities of 45% and 62%. 18F-PSMA-1007 PET/CT was used to correctly differentiate 17 of 26 PI-RADS 3 lesions (65%), with a negative and positive predictive value of 93% and 27%, respectively, for ruling out or detecting csPCa. One additional significant and one insignificant PCa lesion (PI-RADS 1 or 2) were found at 18F-PSMA-1007 PET/CT that otherwise would have remained undetected. Two participants had ISUP 2 tumors without PSMA uptake that were missed at PET/CT. Conclusion 18F-PSMA-1007 PET/CT showed good sensitivity and moderate specificity for the detection of csPCa and ruled this out in 93% of participants with PI-RADS 3 lesions. Clinical trial registration no. NCT04487847 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Turkbey in this issue.
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Affiliation(s)
- Bastiaan M Privé
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Bas Israël
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Marcel J R Janssen
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Marloes M G van der Leest
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Maarten de Rooij
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Jolique A van Ipenburg
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Marianne Jonker
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Steffie M B Peters
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Michel de Groot
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Patrik Zámecnik
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Alexander Hoepping
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Joyce G Bomers
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Martin Gotthardt
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - J P Michiel Sedelaar
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Jelle O Barentsz
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - Inge M van Oort
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
| | - James Nagarajah
- From the Department of Medical Imaging and Nuclear Medicine (B.M.P., B.I., M.J.R.J., M.M.G.v.d.L., M.d.R., S.M.B.P., M.d.G., P.Z., J.G.B., M.G., J.O.B., J.N.), Department of Urology (B.I., J.P.M.S., I.M.v.O.), and Department of Radiation Oncology (B.I.), Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Department of Radiation Oncology, Erasmus Medical Center, Cancer Institute, Rotterdam, the Netherlands (B.M.P.); Department of Pathology (J.A.v.I.) and Department of Health Evidence, Biostatistics Section (M.J.), Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Medicinal Chemistry, ABX Advanced Biochemical Compounds, Radeberg, Germany (A.H.)
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Tateishi U, Kimura K, Tsuchiya J, Kano D, Watabe T, Nonomura N, Saito K, Yokoyama K, Yamagiwa K, Adachi T, Kojima Y, Yoshida S, Fujii Y. Phase I/IIa trial of 18F-prostate specific membrane antigen (PSMA) 1007 PET/CT in healthy volunteers and prostate cancer patients. Jpn J Clin Oncol 2024; 54:282-291. [PMID: 38066703 DOI: 10.1093/jjco/hyad166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/15/2023] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE 18F-PSMA 1007 is a promising PET tracer for prostate cancer. We aimed to examine the safety, biodistribution, radiation dosimetry, and clinical effectiveness in Japanese healthy volunteers and patients with prostate cancer. METHODS Part A evaluated the pharmacokinetics and exposure doses in three healthy volunteers. Part B evaluated the diagnostic accuracy in patients with untreated preoperative prostate cancer (Cohort 1, n = 7) and patients with biochemical recurrence (Cohort 2, n = 3). All subjects received a single dose of 3.7 MBq/kg 18F-PSMA 1007. Results: 18F-PSMA 1007 was found to be safe and well tolerated in all subjects. No serous AEs or drug-related AEs were identified during the present study. The average blood radioactivity concentration reached a maximum of 47.87 ± 1.05 (percentage of injected dose [%ID]/ml) at 5 min and then decreased to 1.60 ± 0.78 in 6 h. The systemic radioactivity reached a maximum of 211.05 ± 6.77 (%ID$\times$103) at 5 min and decreased to 7.18 ± 3.91 in 6 h. The sensitivity and positive predictive value were 100% and 100% based on both pathologic and imaging confirmation as gold standard. In Cohort 1, 15 primary foci (11.9%) were >5 mm in the largest diameter and identified in 39 of 126 segments (30.1%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for 60 min uptake time acquisition were 80.0, 96.5, 91.4, 91.2 and 91.3%, respectively. CONCLUSIONS Our study revealed that 18F-PSMA 1007 was safe, well tolerated and showed high accuracy in the diagnosis of prostate cancer.
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Affiliation(s)
- Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Koichiro Kimura
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Daisuke Kano
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
- Pharmaceutical Department, National Cancer Center Hospital East, Chiba
| | - Tadashi Watabe
- Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, Osaka
| | - Norio Nonomura
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka
| | - Katsuhiko Saito
- Medical & Advanced Equipment Unit, Industrial Equipment Division, Sumitomo Heavy Industries. Ltd., Tokyo
| | - Kota Yokoyama
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Ken Yamagiwa
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Takuya Adachi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Yuji Kojima
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Gammel MCM, Solari EL, Eiber M, Rauscher I, Nekolla SG. A Clinical Role of PET-MRI in Prostate Cancer? Semin Nucl Med 2024; 54:132-140. [PMID: 37652782 DOI: 10.1053/j.semnuclmed.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023]
Abstract
PET/MRI is a relevant application field for prostate cancer management, offering advantages in early diagnosis, staging, and therapy planning. Despite drawbacks such as higher costs, longer acquisition time, and the need for skilled personnel, the technical integration of PET and MRI provides valuable information for detecting primary tumors, identifying metastases, and characterizing the disease, leading to more accurate staging and personalized treatment strategies. However, PET/MRI adoption has been slow, but ongoing technological advancements and AI integration might overcome challenges and improve clinical utility. As precision medicine gains importance in oncology, PET/MRI's multiparametric data can tailor treatment plans to individual patients, providing a comprehensive assessment of tumor biology and aggressiveness for more effective therapeutic strategies.
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Affiliation(s)
- Michael C M Gammel
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Esteban L Solari
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stephan G Nekolla
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
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Tang Y, Ji X, Lin Q, Huang H, Zhu H, Huang X, Xie H, Chen W, Zhuang Y. Status of 18F-PSMA-1007-PET/CT compared with multiparametric MRI in preoperative evaluation of prostate cancer. World J Urol 2023; 41:1017-1024. [PMID: 36932282 DOI: 10.1007/s00345-023-04345-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/24/2023] [Indexed: 03/19/2023] Open
Abstract
PURPOSE Treatment of primary prostate cancer extremely depends on preoperative stage. The role of 18F-1007-PSMA-PET/CT in preoperative staging has not been well defined. Our aim was to compare the diagnostic performance of 18F-1007-PEMA-PET/CT, mpMRI, and mpMRI + PEMA-PET/CT in local progression and lymph node invasion of prostate cancer using histopathology as the gold standard. MATERIALS AND METHODS In this retrospective study, all patients with prostate cancer who underwent mpMRI and 18F-PSMA-1007-PET/CT before operation were included. The role of preoperative imaging was evaluated by predicting the sensitivity and specificity of EPE (extraprostatic extension), SVI (seminal vesicle invasion), and lymph node invasion results. RESULTS Ultimately, 130 patients were included in this study. In the preoperative judgment of EPE and SVI, mpMRI + PSMA-PET/CT had higher sensitivity and specificity. When predicting lymph node metastasis, PSMA-PET/CT was the best choice. The accuracy of mpMRI + PSMA-PET/CT and PSMA-PET/CT in the T and N stages, respectively, was affected by the least factors. CONCLUSIONS Based on the combined results of mpMRI and 18F-1007-PSMA-PET/CT, the accuracy of the preoperative judgment of prostatic capsule invasion can be improved, which may be conducive to developing intra-fascial technology while ensuring no tumor-touch isolation. PSMA-PET/CT has the advantages over mpMRI alone in terms of lymph node positivity. Compared with PSMA-PET/CT alone, the combined results can improve the sensitivity, but reduce specificity. Therefore, it is recommended to focus on PSMA-PET/CT to decide whether lymph node dissection should be performed.
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Affiliation(s)
- Yufan Tang
- Department of Urology, Jiashan County First People's Hospital, Jiaxing, China
| | - Xiaowei Ji
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qi Lin
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hang Huang
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Honghui Zhu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xixi Huang
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hui Xie
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Wei Chen
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Yuandi Zhuang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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6
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Liu FY, Sheng TW, Tseng JR, Yu KJ, Tsui KH, Pang ST, Wang LJ, Lin G. Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET-CT vs PET-MRI. Br J Radiol 2022; 95:20210728. [PMID: 34767482 PMCID: PMC8978229 DOI: 10.1259/bjr.20210728] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate whether PET-CT or PET-MRI is more appropriate for imaging prostate cancer, in terms of primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. METHODS A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET-CT vs PET-MRI in prostate cancer patients were emphasized. RESULTS We reviewed 57 original research articles during the period 2016-2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET-MRI is better than PET-CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET-MRI is likely superior as compared with PET-CT in detecting local recurrence, and has slightly higher detection rates than PET-CT in lymph node recurrence. PET-CT and PET-MRI seem to have equivalent performance in detecting distant bony or visceral metastases. CONCLUSION In conclusion, PET-MRI is suitable for local and regional disease, either primary staging or restaging, whereas PET-CT is valuable for managing distant bony or visceral metastasis. ADVANCES IN KNOWLEDGE We reviewed the emerging applications of PET-MRI and PET-CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET-MRI or PET-CT in the management of prostate cancer.
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Affiliation(s)
- Feng-Yuan Liu
- Department of Nuclear Medicine, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Ting-Wen Sheng
- Department of Medical Imaging and Intervention, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei City, Taiwan
| | - Jing-Ren Tseng
- Department of Nuclear Medicine, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei City, Taiwan
| | - Kai-Jie Yu
- Department of Urology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Ke-Hong Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Se-Tong Pang
- Department of Urology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Wang
- Department of Medical Imaging and Intervention, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei City, Taiwan
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
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Chen C, Margolis DJ. Case of the Season: Prostate Specific Membrane Antigen (PSMA) Positron-Emission Tomography (PET)-MRI to Evaluate Neoadjuvant Radiation Therapy Response. Semin Roentgenol 2021; 56:363-365. [PMID: 34688338 DOI: 10.1053/j.ro.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/08/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Christine Chen
- Department of Radiology, Weill Cornell Medical College: Weill Cornell Medicine, New York, NY.
| | - Daniel J Margolis
- Department of Radiology, Weill Cornell Medical College: Weill Cornell Medicine, New York, NY
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8
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Liu BL, Hong JJ, Tang K, Lin J, Zheng XW. 18F-PSMA-1007 Uptake in Pulmonary Lymphangitic Carcinomatosis Metastasis From Prostate Cancer. Clin Nucl Med 2021; 46:e355-e357. [PMID: 33782286 DOI: 10.1097/rlu.0000000000003582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 55-year-old man with cough, bone pain, and cervical lymphadenopathy underwent both 18F-FDG and 18F-PSMA-1007 PET/CT scans with clinical suspicion of malignant disease. Compared with 18F-FDG PET/CT, 18F-PSMA PET/CT showed intense tracer uptake in the prostate gland, lungs, osteogenic lesions, and multiple lymph nodes. Interestingly, we also found the high tracer concentration of pulmonary lymphangitic carcinomatosis, a very rare form of prostate cancer metastasis to the lung, on 18F-PSMA-1007 PET/CT images.
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9
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Liu A, Zhang M, Huang H, Zhang C, Ruan X, Lin W, Li B, Chen L, Xu D. Clinical Utility of 18F-PSMA-1007 Positron Emission Tomography/Magnetic Resonance Imaging in Prostate Cancer: A Single-Center Experience. Front Oncol 2021; 10:612701. [PMID: 33680933 PMCID: PMC7928386 DOI: 10.3389/fonc.2020.612701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose This study aimed to evaluate the clinical utility of 18F-PSMA-1007 positron emission tomography (PSMA PET)/magnetic resonance imaging (MRI) imaging in patients with suspected or defined prostate cancer. Methods In the pilot study, we retrospectively investigated 62 patients who underwent PSMA-PET/MRI for suspected or defined PCa between June 2019 and June 2020. Patients were grouped into three subgroups: (1) suspected PCa without histological evidence, (2) primary PCa, (3) biochemical recurrent prostate cancer (BRPCa). Two nuclear physicians independently interpreted the results of PSMA-PET/MRI. Management strategies before PSMA-PET/MRI were retrospectively reported, and the management strategy was re-evaluated for each patient considering the PSMA-PET/MRI result. The changes in strategies were recorded. Besides, the correlation between prostate specific antigen (PSA) level and management changes was also accessed by Fisher exact test, and two-side p < 0.05 was assumed as statistical significance. Results There were 28 patients in the suspected PCa group (group 1), 12 in the primary PCa group (group 2), and 22 in the BRPCa group (group 3). Overall, the intended decisions were changed in 26 (41.9%) of 62 patients after PSMA-PET/MRI, including 11/28 (39.3%) in suspected PCa group, 1/12 (8.4%) in primary PCa group, and 14/24 (63.6%) in BCR group. In group 1, the main impact on subsequent management included decreased active surveillance (from 20 to 9) and increased prostate biopsy (from 8 to 19). PSA levels were not significantly associated with management changes in suspected PCa patients (p = 0.865). In group 2, the main impact on subsequent management included decreased radical surgery (from 8 to 7), and multimodal therapy appearance (n = 1). Only in the category of PSA levels of ≥20 ng/ml, the management of primary PCa was changed. In group 3, the main impact on subsequent management included decreased salvage radiotherapy (from 5 to 2), increased systemic therapy (from 6 to 7), and increased multimodal therapy (from 11 to 13). The highest proportion of management changes occurred in BCR patients with 0.5≤PSA<1 ng/ml. Conclusion From our preliminary experience, PSMA-PET/MRI may be a valued tool for defining PCa lesions and changing management. The biggest impact of management intent was in patients with BRPCa, especially in patients with 0.5≤PSA<1 ng/ml. However, further studies are needed to confirm our pilot findings.
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Affiliation(s)
- Ao Liu
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hai Huang
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chuanjie Zhang
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaohao Ruan
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenhao Lin
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lu Chen
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Danfeng Xu
- Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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10
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Aragon-Ching JB. The emerging role of prostate-specific membrane antigen (PSMA) PET-CT in patients with high-risk prostate cancer: moving the bar in high-risk prostate cancer. Asian J Androl 2021; 23:1-2. [PMID: 32719192 PMCID: PMC7831828 DOI: 10.4103/aja.aja_35_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Jeanny B Aragon-Ching
- GU Medical Oncology, Department of Oncology, Inova Schar Cancer Institute, Fairfax, VA, USA
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11
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Evaluating F-18-PSMA-1007-PET in primary prostate cancer and comparing it to multi-parametric MRI and histopathology. Prostate Cancer Prostatic Dis 2020; 24:423-430. [PMID: 32999466 DOI: 10.1038/s41391-020-00292-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/26/2020] [Accepted: 09/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND PSMA-PET is a novel imaging modality for the staging of prostate cancer (PCa). While there are several PSMA ligands available, F-18-PSMA-1007 is particularly of interest as it is not renally excreted and therefore does not impair the imaging of the pelvic area. Hence, this study aimed to investigate the F-18-PSMA-1007-PET for the primary staging of PCa and compared it to multi-parametric (mp) MRI and histopathology. METHODS A retrospective study was performed of men with intermediate and high-risk PCa patients that underwent a F-18-PSMA-1007-PET after mpMRI with subsequent MR-guided target biopsy (MRGB). Suspicious mpMRI lesions and F-18-PSMA-1007-PET were simultaneously reviewed on both a per patient and per-lesion basis. Results were subsequently evaluated with histopathological outcome of MRGB, and if performed, the radical prostatectomy specimen. RESULTS A total of 66 suspicious mpMRI lesions were identified in 53 patients and underwent MRGB. Two lesions had a maximum standardized uptake value (SUVmax) less than the mean SUVmax of healthy prostate tissue and were considered as non-PSMA-expressing. All PSMA avid tumors had higher SUVmax than the mean SUVmean of the bladder/urine, therefore all lesions were clearly distinguishable in the pelvic area. Twenty-three patients received a radical prostatectomy of which the histopathology specimens were evaluated. F-18-PSMA-1007-PET/CT correctly staged seminal vesicle invasion (i.e. pT3b) more often than mpMRI (90 vs. 76%), whereas mpMRI more accurately detected extracapsular extension (i.e. pT3a) compared to F-18-PSMA-1007-PET (90% vs 57%). CONCLUSIONS The present study of a selected cohort suggest that dual imaging with mpMRI and F-18-PSMA-1007-PET may improve staging of primary PCa. F-18-PSMA-1007-PET/CT had low renal clearance, which could assist the evaluation of tumors in proximity of the bladder.
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12
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Cardinale J, Roscher M, Schäfer M, Geerlings M, Benešová M, Bauder-Wüst U, Remde Y, Eder M, Nováková Z, Motlová L, Barinka C, Giesel FL, Kopka K. Development of PSMA-1007-Related Series of 18F-Labeled Glu-Ureido-Type PSMA Inhibitors. J Med Chem 2020; 63:10897-10907. [PMID: 32852205 DOI: 10.1021/acs.jmedchem.9b01479] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In recent years, a number of drugs targeting the prostate-specific membrane antigen (PSMA) have become important tools in the diagnosis and treatment of prostate cancer. In the present work, we report on the synthesis and preclinical evaluation of a series of 18F-labeled PSMA ligands for diagnostic application based on the theragnostic ligand PSMA-617. By applying modifications to the linker structure, insight into the structure-activity relationship could be gained, highlighting the importance of hydrophilicity and stereoselectivity on interaction with PSMA and hence the biodistribution. Selected compounds were co-crystallized with the PSMA protein and analyzed by X-rays with mixed results. Among these, PSMA-1007 (compound 5) showed the best interaction with the PSMA protein. The respective radiotracer [18F]PSMA-1007 was translated into the clinic and is, in the meantime, subject of advanced clinical trials.
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Affiliation(s)
- Jens Cardinale
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Mareike Roscher
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Martin Schäfer
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Max Geerlings
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Martina Benešová
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Ulrike Bauder-Wüst
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Yvonne Remde
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Matthias Eder
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Zora Nováková
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, BIOCEV, Prumyslova 595, 252 50 Vestec, Czech Republic
| | - Lucia Motlová
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, BIOCEV, Prumyslova 595, 252 50 Vestec, Czech Republic
| | - Cyril Barinka
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, BIOCEV, Prumyslova 595, 252 50 Vestec, Czech Republic
| | - Frederik L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg, Germany
| | - Klaus Kopka
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
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13
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Abstract
A 72-year-old man, who is known with a case of metastatic carcinoma of the breast, was referred for F-PMSA 1007 PET/CT with clinical suspicion of synchronous prostate cancer. F-PSMA 1007 PET/CT scan detected no abnormal tracer concentrating lesion in the prostate gland; however, abnormal tracer concentration was noted in soft tissue lesions in left breast, metastatic lymph nodes, and skeletal lesions. Compared with F-FDG PET/CT, more bone lesions were detected on F-PSMA 1007 imaging. The findings of our case open the possibility of imaging metastatic breast cancer with F-PSMA 1007 in men.
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14
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Evangelista L, Zattoni F, Cassarino G, Artioli P, Cecchin D, Dal Moro F, Zucchetta P. PET/MRI in prostate cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2020; 48:859-873. [PMID: 32901351 PMCID: PMC8036222 DOI: 10.1007/s00259-020-05025-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022]
Abstract
Aim In recent years, the clinical availability of scanners for integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) has enabled the practical potential of multimodal, combined metabolic-receptor, anatomical, and functional imaging to be explored. The present systematic review and meta-analysis summarize the diagnostic information provided by PET/MRI in patients with prostate cancer (PCa). Materials and methods A literature search was conducted in three different databases. The terms used were “choline” or “prostate-specific membrane antigen - PSMA” AND “prostate cancer” or “prostate” AND “PET/MRI” or “PET MRI” or “PET-MRI” or “positron emission tomography/magnetic resonance imaging.” All relevant records identified were combined, and the full texts were retrieved. Reports were excluded if (1) they did not consider hybrid PET/MRI; or (2) the sample size was < 10 patients; or (3) the raw data were not enough to enable the completion of a 2 × 2 contingency table. Results Fifty articles were eligible for systematic review, and 23 for meta-analysis. The pooled data concerned 2104 patients. Initial disease staging was the main indication for PET/MRI in 24 studies. Radiolabeled PSMA was the tracer most frequently used. In primary tumors, the pooled sensitivity for the patient-based analysis was 94.9%. At restaging, the pooled detection rate was 80.9% and was higher for radiolabeled PSMA than for choline (81.8% and 77.3%, respectively). Conclusions PET/MRI proved highly sensitive in detecting primary PCa, with a high detection rate for recurrent disease, particularly when radiolabeled PSMA was used. Electronic supplementary material The online version of this article (10.1007/s00259-020-05025-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy.
| | - Fabio Zattoni
- Urology Unit, Department of Medicine, Udine University Hospital, Udine, Italy
| | - Gianluca Cassarino
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy
| | - Paolo Artioli
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy
| | - Fabrizio Dal Moro
- Urology Unit, Department of Medicine, Udine University Hospital, Udine, Italy.,Urology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, Padova, Italy
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15
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Foley RW, Redman SL, Graham RN, Loughborough WW, Little D. Fluorine-18 labelled prostate-specific membrane antigen (PSMA)-1007 positron-emission tomography-computed tomography: normal patterns, pearls, and pitfalls. Clin Radiol 2020; 75:903-913. [PMID: 32782128 DOI: 10.1016/j.crad.2020.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/30/2020] [Indexed: 11/15/2022]
Abstract
Prostate-specific membrane antigen (PSMA)-based positron-emission tomography (PET)-computed tomography (CT) has shown great promise in prostate cancer imaging. This technique has demonstrated particular utility in the staging of high-risk primary cancer and in the localisation of recurrent disease. The use of fluorine-18 PSMA-1007 is advantageous, as it is excreted via the hepatobiliary system rather than urinary and the longer half-life of fluorine-18 compared to gallium tracers, allows for PSMA imaging in centres without a gallium generator. However, imaging with this tracer is not without flaws and areas of ambiguity remain. In this article, the biodistribution, clinical indications, and pearls of 18F-PSMA-1007 PET-CT in patients with prostate cancer will be discussed, as well as the potential pitfalls in the reporting of these studies.
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Affiliation(s)
- R W Foley
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Avon, Bath, BA1 3NG, UK
| | - S L Redman
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Avon, Bath, BA1 3NG, UK
| | - R N Graham
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Avon, Bath, BA1 3NG, UK
| | - W W Loughborough
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Avon, Bath, BA1 3NG, UK
| | - D Little
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Avon, Bath, BA1 3NG, UK.
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16
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Tateishi U. Prostate-specific membrane antigen (PSMA)-ligand positron emission tomography and radioligand therapy (RLT) of prostate cancer. Jpn J Clin Oncol 2020; 50:349-356. [PMID: 32147685 PMCID: PMC7160915 DOI: 10.1093/jjco/hyaa004] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/11/2019] [Accepted: 01/07/2020] [Indexed: 01/29/2023] Open
Abstract
From a clinical perspective, prostate-specific membrane antigen (PSMA) is a valuable target for both diagnosis and radioligand therapy (RLT) of prostate cancer. The term ‘specific’ has been used to characterize a histologic hallmark of overexpression in the membrane of most prostate cancer. Many PSMA ligands have been developed since the previous decade and have been used in several clinical trials and clinical studies. However, procedure, specification, protocol, interpretation criteria, radiation dose, and cost-effectiveness of PSMA ligands have not been fully explained. Regardless of worldwide use of promising PSMA-ligand PET and RLT, it has not been approved in Japan. Expedited introduction of PSMA-ligand PET and RLT to Japan and implementation of clinical study are eager for many patients with prostate cancer.
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Affiliation(s)
- Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo
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17
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Wang R, Shen G, Yang R, Ma X, Tian R. 68Ga-PSMA PET/MRI for the diagnosis of primary and biochemically recurrent prostate cancer: A meta-analysis. Eur J Radiol 2020; 130:109131. [PMID: 32622250 DOI: 10.1016/j.ejrad.2020.109131] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Our meta-analysis aimed to evaluate the diagnostic performance of 68Ga-labelled prostate-specific membrane antigen ligand positron emission tomography/magnetic resonance imaging (68Ga-PSMA PET/MRI) in patients with primary and biochemically recurrent prostate cancer (PCa). METHODS We searched for relevant articles in PubMed, EMBASE, the Cochrane Library and Web of Science until September 12, 2019. Studies regarding the diagnostic performance of68Ga-PSMA PET/MRI in detecting primary PCa and biochemical recurrence (BCR) after definitive treatment were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The pooled sensitivity and specificity of PET/MRI in identifying primary PCa and the pooled detection rate of PET/MRI for BCR were calculated using a random-effects model. RESULTS A total of 13 studies with 707 patients were included in the analysis, and the pooled sensitivity and specificity of PET/MRI in detecting primary PCa were 0.83 (95 % CI, 0.73-0.90) and 0.81 (95 % CI, 0.61-0.93), respectively. In the pooled analysis of BCR, the pooled detection rate was 76 % (95 % CI, 72 %-79 %). For four levels of PSA (0-0.2 ng/mL, 0.2-1 ng/mL, 1-2 ng/mL and more than 2 ng/mL), the pooled detection rates were 38 %, 67 %, 74 %, and 95 %, respectively. There was no distinct publication bias, but there was significant study heterogeneity. CONCLUSIONS 68Ga-PSMA PET/MRI is likely an effective imaging method in the diagnosis of primary PCa. In addition, the diagnostic accuracy of 68Ga-PSMA PET/MRI in patients with BCR was also high, positively correlating with PSA levels.
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Affiliation(s)
- Rang Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Guohua Shen
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruoning Yang
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China; West China Hospital, West China School of Medicine, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Rong Tian
- Department of Nuclear Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Khoo CC, Miah S, Connor MJ, Tam J, Winkler M, Ahmed HU, Shah TT. A systematic review of salvage focal therapies for localised non-metastatic radiorecurrent prostate cancer. Transl Androl Urol 2020; 9:1535-1545. [PMID: 32676441 PMCID: PMC7354313 DOI: 10.21037/tau.2019.08.21] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
Although radiotherapy to the prostate for cancer is effective, recurrence occurs in 10-15% within 5 years. Traditional salvage treatments for men with radiorecurrent prostate cancer comprise of watchful waiting (WW) with or without androgen deprivation therapy (ADT) or radical prostatectomy (RP). Neither strategy provides ideal therapeutic ratios. Salvage focal ablation is an emerging option. We performed a systematic review of the Medline and Embase databases for studies reporting outcomes of focal salvage brachytherapy (sBT), cryotherapy (sCT) or high-intensity focused ultrasound (sHIFU) for radiorecurrent prostate cancer (conception to April 2019). Results were screened for inclusion against predetermined eligibility criteria. Certain data were extracted, including rates of biochemical disease-free survival (BDFS), metastasis, conversion to second-line therapies and adverse events. Of a total 134 articles returned from the search, 15 studies (14 case series and 1 comparative study) reported outcomes after focal sBT [5], sCT [7] and sHIFU [3]. Cohort size varied depending on intervention, with eligible studies of sBT being small case series. Median follow-up ranged from 10 to 56 months. Although pre-salvage demographics were similar [median age range, 61-75 years; prostate-specific antigen (PSA) range, 2.8-5.5 ng/mL], there was heterogeneity in patient selection, individual treatment protocols and outcome reporting. At 3 years, BDFS ranged from 61% to 71.4% after sBT, 48.1-72.4% after sCT and 48% after sHIFU. Only studies of sCT reported 5-year BDFS, which ranged from 46.5% to 54.4%. Rates of metastasis were low after all salvage modalities, as were conversion to second-line therapies (although this was poorly reported). Grade 3 adverse events were rare. This systematic review indicates that salvage focal ablation of radiorecurrent prostate cancer provides acceptable oncological outcomes and is well tolerated. Unfortunately, there is heterogeneity in the study design of existing evidence. Level 1 research comparing salvage focal therapies to existing whole-gland strategies is needed to further establish the role of these promising treatments.
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Affiliation(s)
- Christopher C. Khoo
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Saiful Miah
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Martin J. Connor
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Joseph Tam
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Mathias Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Hashim U. Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Taimur T. Shah
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Surgery and Interventional Sciences, University College London, London, UK
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Marafi F, Sasikumar A, Alfeeli M, Fathallah W. 18F-PSMA 1007 Uptake in Brain Metastases From Breast Cancer. Clin Nucl Med 2020; 45:e77-e79. [PMID: 31693624 DOI: 10.1097/rlu.0000000000002821] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 64-year-old woman with metastatic breast cancer on follow-up had suspicious recurrent brain metastases. She underwent F-FDG PET/CT, F-PSMA 1007 brain PET/CT, and brain MRI. F-PSMA 1007 showed intense tracer localization in the suspected recurrent brain metastasis in right parietal lobe and also picked up 2 more metastatic brain lesions, which had concurrent findings of metastasis in subsequent MRI. Our case highlights the feasibility of F-PSMA 1007 PET/CT imaging of brain metastases from nonprostate cancers. It may be used as surrogate imaging tracer for potential theranostic application using alpha or beta emitters considering its similarity to PSMA-617.
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Affiliation(s)
- Fahad Marafi
- From the Jaber Alahmad Centre for Molecular Imaging, Shuwaikh, Kuwait
| | - Arun Sasikumar
- St Gregorios International Cancer Care Centre, Parumala, Pathanmthitta, Kerala, India
| | - Mahmoud Alfeeli
- From the Jaber Alahmad Centre for Molecular Imaging, Shuwaikh, Kuwait
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Prostate-Specific Membrane Antigen PET/Magnetic Resonance Imaging for the Planning of Salvage Radiotherapy in Patients with Prostate Cancer with Biochemical Recurrence After Radical Prostatectomy. PET Clin 2019; 14:487-498. [PMID: 31472746 DOI: 10.1016/j.cpet.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article presents an overview of the current literature on PET imaging with prostate-specific membrane antigen ligands, especially focusing on the potential role of simultaneous PET/magnetic resonance imaging for the planning of salvage radiotherapy in patients with prostate cancer with biochemical recurrence after radical prostatectomy.
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Li M, Huang Z, Yu H, Wang Y, Zhang Y, Song B. Comparison of PET/MRI with multiparametric MRI in diagnosis of primary prostate cancer: A meta-analysis. Eur J Radiol 2019; 113:225-231. [PMID: 30927951 DOI: 10.1016/j.ejrad.2019.02.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This meta-analysis aimed to compare the diagnostic performance of positron emission tomography (PET)/MRI using various radiotracers with multiparametric (mp) MRI for detection of primary prostate cancer (PCa). METHODS A systematic literature search up to January 2019 was performed to identify studies that evaluated the diagnostic value of PET/MRI and mpMRI for detection of PCa in the same patient cohorts and had sufficient data to construct 2 × 2 contingency tables for true-positive (TP), false-positive (FP), false-negative (FN), and true-negative (TN) results. The quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, and pooled sensitivity (SEN) and specificity (SPE) were calculated. Summary receiver operating characteristic (ROC) curves and area under the curves (AUCs) were used to compare the performances of PET/MRI and mpMRI. RESULTS We identified 9 eligible studies that included a total of 353 patients. PET/MRI had a SEN of 0.783 (95% CI, 0.758-0.807) and a SPE of 0.899 (95% CI, 0.879-0.917), and mpMRI had a SEN of 0.603 (95% CI, 0.574-0.631) and a SPE of 0.887 (95% CI, 0.866-0.906). PET/MRI had a higher AUC than mpMRI (0.9311, 95% CI, 0.8990-0.9632 vs. 0.8403, 95% CI, 0.7864-0.8942; P = 0.0036). There was no notable publication bias, but there was medium heterogeneity in outcomes. The meta-regression analysis showed the major potential cause of heterogeneity was the use of region-based rather than lesion-based analysis. CONCLUSION PET/MRI has very good diagnostic performance and outperforms mpMRI for the diagnosis of primary PCa.
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Affiliation(s)
- Mou Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Zixing Huang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Haopeng Yu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yi Wang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yongchang Zhang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China.
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Barbosa FDG, Queiroz MA, Nunes RF, Marin JFG, Buchpiguel CA, Cerri GG. Clinical perspectives of PSMA PET/MRI for prostate cancer. Clinics (Sao Paulo) 2018; 73:e586s. [PMID: 30281701 PMCID: PMC6142859 DOI: 10.6061/clinics/2018/e586s] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/16/2018] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer imaging has become an important diagnostic modality for tumor evaluation. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has been extensively studied, and the results are robust and promising. The advent of the PET/magnetic resonance imaging (MRI) has added morphofunctional information from the standard of reference MRI to highly accurate molecular information from PET. Different PSMA ligands have been used for this purpose including 68gallium and 18fluorine-labeled PET probes, which have particular features including spatial resolution, imaging quality and tracer biodistribution. The use of PSMA PET imaging is well established for evaluating biochemical recurrence, even at low prostate-specific antigen (PSA) levels, but has also shown interesting applications for tumor detection, primary staging, assessment of therapeutic responses and treatment planning. This review will outline the potential role of PSMA PET/MRI for the clinical assessment of PCa.
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Affiliation(s)
- Felipe de Galiza Barbosa
- Departamento de Radiologia, Hospital Sirio-Libanes, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Marcelo Araújo Queiroz
- Departamento de Radiologia, Hospital Sirio-Libanes, Sao Paulo, SP, BR
- Instituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - José Flávio Gomes Marin
- Departamento de Radiologia, Hospital Sirio-Libanes, Sao Paulo, SP, BR
- Instituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Carlos Alberto Buchpiguel
- Departamento de Radiologia, Hospital Sirio-Libanes, Sao Paulo, SP, BR
- Instituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Giovanni Guido Cerri
- Departamento de Radiologia, Hospital Sirio-Libanes, Sao Paulo, SP, BR
- Instituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Oh SW, Cheon GJ. Prostate-Specific Membrane Antigen PET Imaging in Prostate Cancer: Opportunities and Challenges. Korean J Radiol 2018; 19:819-831. [PMID: 30174470 PMCID: PMC6082771 DOI: 10.3348/kjr.2018.19.5.819] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/02/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of this systematic review was to describe the characteristics of prostate-specific membrane antigen (PSMA)-targeting PET and their clinical applications in prostate cancer patients. There have been major strides in the design, synthesis of PSMA-targeting PET tracers over the past several years. PSMA-targeting PET tracers can be categorized, according to positron emitters and targeting strategies for the PSMA. The majority of PSMA PET studies has been focused on patients with biochemical recurrence, but additional values of PSMA PET have also been investigated for use in primary staging, treatment planning, response evaluation, and PSMA radioligand therapy. PSMA PET is expected to bring improvements in the management of patients, but the impact of improved diagnosis by PSMA on overall survival remains unanswered. Many challenges still await PSMA PET to expedite the use in the clinical practice. At this early stage, prospective multicenter trials are needed to validate the effectiveness and usefulness of PSMA PET.
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Affiliation(s)
- So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul 07061, Korea
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
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Fanti S, Bonfiglioli R, Decristoforo C. Highlights of the 30th Annual Congress of the EANM, Vienna 2017: "Yes we can - make nuclear medicine great again". Eur J Nucl Med Mol Imaging 2018; 45:1781-1794. [PMID: 29725717 PMCID: PMC6097758 DOI: 10.1007/s00259-018-4029-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
The 30th Annual Congress of the European Association of Nuclear Medicine (EANM) was held in Vienna, Austria, from 21 to 25 October 2017 under the chairmanship of Professor Francesco Giammarile. As always, the Congress was a great success: more than 6,379 participants came from 90 countries from all continents. Participants were presented with an excellent programme consisting of symposia, and scientific and featured sessions, CME sessions, and plenary lectures. These lectures were devoted to nuclear medicine imaging and therapy, including hybrid imaging and molecular life sciences. Additionally, the latest technology and innovations in the field were presented, and added to the success of the Congress. This review summarizes the major scientific contributions which were selected from more than 1,900 submitted abstracts, and presented in the closing highlights session. They cover the diverse areas of nuclear medicine, with particular focus on oncology, cardiovascular science, neurology, technological innovation and novel tracers, and also other clinical sciences. A particular focus of the Congress was on targeted radionuclide-based therapies, which all show promising and great innovations. The Congress was a unique opportunity to be thoroughly updated on this research. This Highlights Lecture could only be a brief summary of the large amount of data presented and discussed during the meeting, which can be found in much greater detail in the Congress proceedings book, published as volume 44, supplement 2 of the European Journal of Nuclear Medicine and Molecular Imaging in October 2017.
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Affiliation(s)
- Stefano Fanti
- Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Rachele Bonfiglioli
- Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria.
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Abstract
Treatment of high-risk prostate cancer (HRPCa) is challenging. Local staging and metastatic evaluation are important for the patient management. Recently, prostate-specific membrane antigen (PSMA)-based imaging modalities such as PSMA PET/CT and PET/MRI have received significant attention for detection of recurrent prostate cancer sites with elevated prostate-specific antigen levels, after therapy. Current evidence suggests that these imaging modalities may also have a role for the management of patients with HRPCa. In this review, we discuss PSMA-based imaging modalities in the management of patients with HRPCa.
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Evolución de la Medicina Nuclear en el diagnóstico y tratamiento de pacientes con cáncer de próstata. Rev Esp Med Nucl Imagen Mol 2018; 37:71-72. [DOI: 10.1016/j.remn.2017.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/25/2017] [Indexed: 11/18/2022]
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García Velloso M, Rodríguez Fraile M. Evolution of nuclear medicine in the diagnosis and treatment of prostate cancer. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cardinale J, Martin R, Remde Y, Schäfer M, Hienzsch A, Hübner S, Zerges AM, Marx H, Hesse R, Weber K, Smits R, Hoepping A, Müller M, Neels OC, Kopka K. Procedures for the GMP-Compliant Production and Quality Control of [ 18F]PSMA-1007: A Next Generation Radiofluorinated Tracer for the Detection of Prostate Cancer. Pharmaceuticals (Basel) 2017; 10:E77. [PMID: 28953234 PMCID: PMC5748634 DOI: 10.3390/ph10040077] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 11/16/2022] Open
Abstract
Radiolabeled tracers targeting the prostate-specific membrane antigen (PSMA) have become important radiopharmaceuticals for the PET-imaging of prostate cancer. In this connection, we recently developed the fluorine-18-labelled PSMA-ligand [18F]PSMA-1007 as the next generation radiofluorinated Glu-ureido PSMA inhibitor after [18F]DCFPyL and [18F]DCFBC. Since radiosynthesis so far has been suffering from rather poor yields, novel procedures for the automated radiosyntheses of [18F]PSMA-1007 have been developed. We herein report on both the two-step and the novel one-step procedures, which have been performed on different commonly-used radiosynthesisers. Using the novel one-step procedure, the [18F]PSMA-1007 was produced in good radiochemical yields ranging from 25 to 80% and synthesis times of less than 55 min. Furthermore, upscaling to product activities up to 50 GBq per batch was successfully conducted. All batches passed quality control according to European Pharmacopoeia standards. Therefore, we were able to disclose a new, simple and, at the same time, high yielding production pathway for the next generation PSMA radioligand [18F]PSMA-1007. Actually, it turned out that the radiosynthesis is as easily realised as the well-known [18F]FDG synthesis and, thus, transferable to all currently-available radiosynthesisers. Using the new procedures, the clinical daily routine can be sustainably supported in-house even in larger hospitals by a single production batch.
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Affiliation(s)
- Jens Cardinale
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - René Martin
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Yvonne Remde
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Martin Schäfer
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Antje Hienzsch
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Sandra Hübner
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Anna-Maria Zerges
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Heike Marx
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Ronny Hesse
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Klaus Weber
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Rene Smits
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Alexander Hoepping
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Marco Müller
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454 Radeberg, Germany.
| | - Oliver C Neels
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Klaus Kopka
- German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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