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Srinivasan R, Cook GJR, Patel N, Subesinghe M. Prostate specific membrane antigen (PSMA) avid nonprostatic benign and malignant disease: a pictorial review. Clin Radiol 2024; 79:639-656. [PMID: 38926052 DOI: 10.1016/j.crad.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Prostate specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) is revolutionising the management of prostate cancer (PC) in primary staging and assessment of biochemical recurrence (BCR) through its higher diagnostic accuracy compared to both conventional imaging and previously available PET radiopharmaceuticals. PSMA is a transmembrane glycoprotein, highly expressed in prostate cancer, with its extracellular domain the target for PSMA PET radiopharmaceuticals. However, PSMA expression is not prostate specific and resultant PSMA uptake on PET-CT is not restricted to pathologies arising from the prostate gland. The increasing use of PSMA PET-CT has revealed PSMA uptake in a variety of non-prostatic benign and malignant diseases, which adds complexity to PET-CT interpretation and subsequent clinical management. This pictorial review will provide a thorough knowledge and understanding of the comprehensive range of PSMA avid non-prostatic benign and malignant diseases demonstrable on PSMA PET-CT, whilst highlighting the complimentary nature of other imaging modalities.
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Affiliation(s)
- R Srinivasan
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - G J R Cook
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - N Patel
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Subesinghe
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
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2
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Cui Y, Zhou X, Song Y, Zhai S, Li N. The Value of PSMA-RADS Version 2.0 in the Assessment of Pulmonary Metastases in Patients With Prostate Cancer and the Improvement of Differential Diagnosis Efficiency by PSMA PET/CT Parameters. Clin Nucl Med 2024:00003072-990000000-01251. [PMID: 39192508 DOI: 10.1097/rlu.0000000000005409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
PURPOSE The aim of this study was to investigate the application of PSMA-RADS version 2.0 in assessment of pulmonary metastases in patients with prostate cancer and whether PSMA PET/CT parameters provide incremental value. PATIENTS AND METHODS From October 2016 to July 2023, PC patients with pulmonary opacities (including pulmonary metastases, lung cancer, and pulmonary benign opacities) who underwent Al18F-PSMA-BCH PET/CT scans were retrospectively analyzed. CT imaging characteristics, including the longest diameter, density, smoothness, lobulation, pleural retraction, and vacuole sign, as well as PET parameters including SUVmax and tumor-to-background ratio, were measured and analyzed. Additionally, the pulmonary PSMA-RADS score for each patient was determined. Independent predictors of pulmonary metastases were identified through univariate analysis and multivariate logistic regression analysis, which were utilized to construct a parallel diagnostic test. The differential diagnostic performances were evaluated using receiver operating characteristic analysis. RESULTS A total of 148 pulmonary opacities from 96 patients were retrospectively included. The number of pulmonary benign opacities, lung cancer, and pulmonary metastases were 48 (32.4%), 20 (13.5%), and 80 (54.1%), respectively. The number of opacities across different PSMA-RADS scores from 2 to 5 was 8 (5.4%), 88 (59.5%), 7 (4.7%), and 45 (30.4%). SUVmax and smooth edges were independent predictors of pulmonary metastases (both P < 0.05), and the AUC of the parallel test for these 2 parameters was 0.86 (95% confidence interval: 0.79, 0.94; P < 0.001). Furthermore, the diagnostic accuracy of the parallel test across PSMA-RADS score from 2 to 5 was 85.7%, 79.6%, 100%, and 92.9%, respectively. CONCLUSIONS Al18F-PSMA-BCH PET/CT parameters were helpful in differentiating pulmonary metastases in PC patients and provided incremental value when integrated with PSMA-RADS version 2.0.
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Affiliation(s)
- Yan Cui
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
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Mahmoud AM, Moustafa A, Day C, Ahmed ME, Zeina W, Marzouk UM, Basourakos S, Haloi R, Mahon M, Muniz M, Childs DS, Orme JJ, Riaz IB, Kendi AT, Stish BJ, Davis BJ, Kwon ED, Andrews JR. Prostate Cancer Lung Metastasis: Clinical Insights and Therapeutic Strategies. Cancers (Basel) 2024; 16:2080. [PMID: 38893199 PMCID: PMC11171228 DOI: 10.3390/cancers16112080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Prostate cancer lung metastasis represents a clinical conundrum due to its implications for advanced disease progression and the complexities it introduces in treatment planning. As the disease progresses to distant sites such as the lung, the clinical management becomes increasingly intricate, requiring tailored therapeutic strategies to address the unique characteristics of metastatic lesions. This review seeks to synthesize the current state of knowledge surrounding prostate cancer metastasis to the lung, shedding light on the diverse array of clinical presentations encountered, ranging from subtle radiological findings to overt symptomatic manifestations. By examining the diagnostic modalities utilized in identifying this metastasis, including advanced imaging techniques and histopathological analyses, this review aims to provide insights into the diagnostic landscape and the challenges associated with accurately characterizing lung metastatic lesions in prostate cancer patients. Moreover, this review delves into the nuances of therapeutic interventions employed in managing prostate cancer lung metastasis, encompassing systemic treatments such as hormonal therapies and chemotherapy, as well as metastasis-directed therapies including surgery and radiotherapy.
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Affiliation(s)
- Ahmed M. Mahmoud
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Amr Moustafa
- Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA
| | - Carter Day
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Mohamed E. Ahmed
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Wael Zeina
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Usama M. Marzouk
- Department of Internal Medicine, Ain Shams University, Cairo 11566, Egypt
| | | | - Rimki Haloi
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Mindie Mahon
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
| | - Miguel Muniz
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel S. Childs
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Jacob J. Orme
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Irbaz Bin Riaz
- Department of Medical Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - A. Tuba Kendi
- Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Bradley J. Stish
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Brian J. Davis
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Eugene D. Kwon
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.M.)
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4
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Corpetti M, Müller C, Beltran H, de Bono J, Theurillat JP. Prostate-Specific Membrane Antigen-Targeted Therapies for Prostate Cancer: Towards Improving Therapeutic Outcomes. Eur Urol 2024; 85:193-204. [PMID: 38104015 DOI: 10.1016/j.eururo.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023]
Abstract
CONTEXT Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein overexpressed in most prostate cancers and exploited as a target for PSMA-targeted therapies. Different approaches to target PSMA-expressing cancer cells have been developed, showing promising results in clinical trials. OBJECTIVE To discuss the regulation of PSMA expression and the main PSMA-targeted therapeutic concepts illustrating their clinical development and rationalizing combination approaches with examples. EVIDENCE ACQUISITION We performed a detailed literature search using PubMed and reviewed the American Society of Clinical Oncology and European Society of Medical Oncology annual meeting abstracts up to September 2023. EVIDENCE SYNTHESIS We present an overarching description of the different strategies to target PSMA. The outcomes of PSMA-targeted therapies strongly rely on surface-bound PSMA expression. However, PSMA heterogeneity at different levels (interpatient and inter/intratumoral) limits the efficacy of PSMA-targeted therapies. We highlight the molecular mechanisms governing PSMA regulation, the understanding of which is crucial to designing therapeutic strategies aimed at upregulating PSMA expression. Thus far, homeobox B13 (HOXB13) and androgen receptor (AR) have emerged as critical transcription factors positively and negatively regulating PSMA expression, respectively. Furthermore, epigenetic regulation of PSMA has been also reported recently. In addition, many established therapeutic approaches harbor the potential to upregulate PSMA levels as well as potentiate DNA damage mediated by current radioligands. CONCLUSIONS PSMA-targeted therapies are rapidly advancing, but their efficacy is strongly limited by the heterogeneous expression of the target. A thorough comprehension of how PSMA is regulated will help improve the outcomes through increasing PSMA expression and will provide the basis for synergistic combination therapies. PATIENT SUMMARY Prostate-specific membrane antigen (PSMA) is overexpressed in most prostate cancers. PSMA-targeted therapies have shown promising results, but the heterogeneous expression of PSMA limits their efficacy. We propose to better elucidate the regulation of PSMA expression to increase the levels of the target and improve the therapeutic outcomes.
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Affiliation(s)
- Matteo Corpetti
- Institute of Oncology Research, Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Cristina Müller
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland; Center for Radiopharmaceutical Sciences ETH-PSI, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Himisha Beltran
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Johann de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | - Jean-Philippe Theurillat
- Institute of Oncology Research, Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.
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Voter AF, Werner RA, Savas H, Gafita A, Ross AE, Gorin MA, Solnes LB, Pomper MG, Rowe SP, Sheikhbahaei S. A Practical Guide to the Pearls and Pitfalls of PSMA PET Imaging. Semin Nucl Med 2024; 54:119-131. [PMID: 37980186 DOI: 10.1053/j.semnuclmed.2023.11.001] [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: 09/10/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/20/2023]
Abstract
Prostate-specific membrane antigen (PSMA)-targeted PET agents have revolutionized the care of patients with prostate cancer, supplanting traditional methods of imaging prostate cancer, and improving the selection and delivery of therapies. This has led to a rapid expansion in both the number of PSMA PET scans performed and the imaging specialists required to interpret those scans. To aid those imagers and clinicians who are new to the interpretation of PSMA PET, this review provides an overview of the interpretation of PSMA PET/CT imaging and pearls for overcoming commonly encountered pitfalls. We discuss the physiologic distribution of the clinically available PSMA-targeted radiotracers, the commonly encountered patterns of prostate cancer spread, as well as the benign and malignant mimics of prostate cancer. Additionally, we review the standardized PSMA PET reporting systems and the role of PSMA in selecting appropriate patients for PSMA-targeted therapies.
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Affiliation(s)
- Andrew F Voter
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rudolf A Werner
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Hatice Savas
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Andrei Gafita
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ashley E Ross
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael A Gorin
- Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lilja B Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Martin G Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven P Rowe
- Department of Radiology, University of North Carolina, Chapel Hill, NC.
| | - Sara Sheikhbahaei
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
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Bunnag N, Wongwijitsook J, Vachatimanont S. Synchronous Pulmonary Malignancy Detected During PSMA Ligand PET/CT for Initial Staging of Prostate Cancer: a Case Report. Nucl Med Mol Imaging 2023; 57:287-290. [PMID: 37982101 PMCID: PMC10654289 DOI: 10.1007/s13139-023-00798-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 04/08/2023] Open
Abstract
We present a case of an 83-year-old man with underlying colorectal cancer who underwent a gallium-68 prostate specific membrane antigen-11 positron emission tomography/computed tomography (68 Ga-PSMA-11 PET/CT) for the initial staging of prostate cancer. PET / CT revealed two mildly PSMA-avid lung nodules without evidence of PSMA-avid nodal or bony metastasis. Subsequently, a wedge pulmonary resection was performed and the histopathology and immunohistochemistry of the nodules were consistent with synchronous primary lung cancer. Because differentiating synchronous primary lung cancer from pulmonary metastasis of prostate cancer can significantly affect treatment strategies and pulmonary metastasis rarely presents during initial staging of prostate cancer, synchronous primary lung cancer should be included in the differential diagnosis of pulmonary lesions in initial staging of 68 Ga-PSMA-11 PET/CT regardless of PSMA avidity. The lack of nodal or bony metastases also decreases the likelihood of lung metastasis, and a tissue diagnosis may be required.
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Affiliation(s)
- Napisa Bunnag
- Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jirarot Wongwijitsook
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathum Wan, Bangkok, Thailand
| | - Sira Vachatimanont
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathum Wan, Bangkok, Thailand
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7
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Huang ZG, Chen Y, Wu T, Yin BT, Feng X, Li SH, Li DM, Chen G, Cheng JW, He J. What should be the future direction of development in the field of prostate cancer with lung metastasis? World J Clin Oncol 2023; 14:420-439. [PMID: 37970109 PMCID: PMC10631347 DOI: 10.5306/wjco.v14.i10.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Since the start of the 21st century, prostate cancer with lung metastasis (PCLM) has accumulated significant scientific research output. However, a systematic knowledge framework for PCLM is still lacking. AIM To reconstruct the global knowledge system in the field of PCLM, sort out hot research directions, and provide reference for the clinical and mechanism research of PCLM. METHODS We retrieved 280 high-quality papers from the Web of Science Core Collection and conducted a bibliometric analysis of keywords, publication volume, and citation frequency. Additionally, we selected differentially expressed genes from global high-throughput datasets and performed enrichment analysis and protein-protein interaction analysis to further summarize and explore the mechanisms of PCLM. RESULTS PCLM has received extensive attention over the past 22 years, but there is an uneven spatial distribution in PCLM research. In the clinical aspect, the treatment of PCLM is mainly based on chemotherapy and immunotherapy, while diagnosis relies on methods such as prostate-specific membrane antigen positron emission tomography/computed tomography. In the basic research aspect, the focus is on cell adhesion molecules and signal transducer and activator of transcription 3, among others. Traditional treatments, such as chemotherapy, remain the mainstay of PCLM treatment, while novel approaches such as immunotherapy have limited effectiveness in PCLM. This study reveals for the first time that pathways related to coronavirus disease 2019, cytokine-cytokine receptor interaction, and ribosome are closely associated with PCLM. CONCLUSION Future research should focus on exploring and enhancing mechanisms such as cytokine-cytokine receptor interaction and ribosome and improve existing mechanisms like cadherin binding and cell adhesion molecules.
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Affiliation(s)
- Zhi-Guang Huang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yi Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Tong Wu
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Bin-Tong Yin
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Xiao Feng
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Sheng-Hua Li
- Department of Urology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Dong-Ming Li
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Ji-Wen Cheng
- Department of Urology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Juan He
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Okudan B, Seven B, Ural B, Çapraz M. Detection of COVID-19 Incidentally in 68Ga-PSMA PET/CT for Restaging of Prostate Cancer. Curr Med Imaging 2022; 18:1532-1535. [PMID: 35490331 DOI: 10.2174/1573405618666220427134647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND A series of pneumonia cases with clinical presentations of viral pneumonia secondary to new coronavirus and subsequent global transmission arose in Wuhan, Hubei, China, in December 2019. Several cases of coronavirus disease 2019 (COVID-19) have been described incidentally in positron emission tomography-computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) as a result of the pandemic. Herein, we describe the findings of a patient with unknown COVID-19 in PET/CT with the other radiopharmaceutical, 68Ga-labeled prostatespecific membrane antigen (68Ga-PSMA). CASE REPORT A 69-year-old man had previously undergone radical prostatectomy for adenocarcinoma. 68Ga-PSMA PET/CT imaging was performed due to biochemical recurrence. 68Ga-PSMA uptake in the prostate bed suggestive of local recurrence was detected in PET/CT images. Also, bilateral groundglass opacities with slightly increased 68Ga-PSMA uptake were seen in the lungs, suspected of COVID-19. A reverse transcription-polymerase chain reaction test has confirmed the infection. CONCLUSION Even in asymptomatic patients, nuclear medicine departments must be aware of the possibility of COVID-19, take appropriate post-exposure procedures, and protect employees and other patients.
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Affiliation(s)
- Berna Okudan
- Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Bedri Seven
- Department of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, University of Amasya, Amasya, Turkey
| | - Betül Ural
- Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Çapraz
- Department of Internal Medicine, School of Medicine, University of Amasya, Amasya, Turkey
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PSMA PET for the Evaluation of Liver Metastases in Castration-Resistant Prostate Cancer Patients: A Multicenter Retrospective Study. Cancers (Basel) 2022; 14:cancers14225680. [PMID: 36428771 PMCID: PMC9688898 DOI: 10.3390/cancers14225680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: To evaluate the diagnostic performance of PSMA-PET compared to conventional imaging/liver biopsy in the detection of liver metastases in CRPC patients. Moreover, we evaluated a PSMA-PET/CT-based radiomic model able to identify liver metastases. Methods: Multicenter retrospective study enrolling patients with the following inclusion criteria: (a) proven CRPC patients, (b) PSMA-PET and conventional imaging/liver biopsy performed in a 6 months timeframe, (c) no therapy changes between PSMA-PET and conventional imaging/liver biopsy. PSMA-PET sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for liver metastases were calculated. After the extraction of radiomic features, a prediction model for liver metastases identification was developed. Results: Sixty CRPC patients were enrolled. Within 6 months before or after PSMA-PET, conventional imaging and liver biopsy identified 24/60 (40%) patients with liver metastases. PSMA-PET sensitivity, specificity, PPV, NPV, and accuracy for liver metastases were 0.58, 0.92, 0.82, 0.77, and 0.78, respectively. Either number of liver metastases and the maximum lesion diameter were significantly associated with the presence of a positive PSMA-PET (p < 0.05). On multivariate regression analysis, the radiomic feature-based model combining sphericity, and the moment of inverse difference (Idm), had an AUC of 0.807 (95% CI:0.686-0.920). Conclusion: For liver metastases assessment, [68Ga]Ga-PSMA-11-PET demonstrated moderate sensitivity while high specificity, PPV, and inter-reader agreement compared to conventional imaging/liver biopsy in CRPC patients.
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10
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Kurokawa R, Kato S, Koyama H, Ishida M, Kurokawa M, Kuroda R, Ushiku T, Kume H, Abe O. Osteolytic or mixed bone metastasis is not uncommon in patients with high-grade prostate cancer. Eur J Radiol 2022; 157:110595. [DOI: 10.1016/j.ejrad.2022.110595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/18/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
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11
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Combes AD, Palma CA, Calopedos R, Wen L, Woo H, Fulham M, Leslie S. PSMA PET-CT in the Diagnosis and Staging of Prostate Cancer. Diagnostics (Basel) 2022; 12:2594. [PMID: 36359439 PMCID: PMC9689635 DOI: 10.3390/diagnostics12112594] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 08/07/2023] Open
Abstract
Prostate cancer is the most common cancer and the second leading cause of cancer death in men. The imaging assessment and treatment of prostate cancer has vastly improved over the past decade. The introduction of PSMA PET-CT has improved the detection of loco-regional and metastatic disease. PSMA PET-CT also has a role in the primary diagnosis and staging, in detecting biochemical recurrence after curative treatment and in metastasis-directed therapy. In this paper we review the role of PSMA PET-CT in prostate cancer.
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Affiliation(s)
- Alexander D. Combes
- Department of Urology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Catalina A. Palma
- Department of Urology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Ross Calopedos
- Department of Urology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Lingfeng Wen
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Engineering and Computer Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Henry Woo
- Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia
- Department of Urology, Chris O’Brien Lifehouse, Sydney, NSW 2050, Australia
| | - Michael Fulham
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia
| | - Scott Leslie
- Department of Urology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia
- Department of Urology, Chris O’Brien Lifehouse, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery, Sydney, NSW 2050, Australia
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12
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Zhu J, Pan F, Cai H, Pan L, Li Y, Li L, Li Y, Wu X, Fan H. Positron emission tomography imaging of lung cancer: An overview of alternative positron emission tomography tracers beyond F18 fluorodeoxyglucose. Front Med (Lausanne) 2022; 9:945602. [PMID: 36275809 PMCID: PMC9581209 DOI: 10.3389/fmed.2022.945602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Lung cancer has been the leading cause of cancer-related mortality in China in recent decades. Positron emission tomography-computer tomography (PET/CT) has been established in the diagnosis of lung cancer. 18F-FDG is the most widely used PET tracer in foci diagnosis, tumor staging, treatment planning, and prognosis assessment by monitoring abnormally exuberant glucose metabolism in tumors. However, with the increasing knowledge on tumor heterogeneity and biological characteristics in lung cancer, a variety of novel radiotracers beyond 18F-FDG for PET imaging have been developed. For example, PET tracers that target cellular proliferation, amino acid metabolism and transportation, tumor hypoxia, angiogenesis, pulmonary NETs and other targets, such as tyrosine kinases and cancer-associated fibroblasts, have been reported, evaluated in animal models or under clinical investigations in recent years and play increasing roles in lung cancer diagnosis. Thus, we perform a comprehensive literature review of the radiopharmaceuticals and recent progress in PET tracers for the study of lung cancer biological characteristics beyond glucose metabolism.
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Affiliation(s)
- Jing Zhu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China,Respiratory and Critical Care Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China,NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Fei Pan
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Huawei Cai
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lili Pan
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yalun Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Li
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - YunChun Li
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China,Department of Nuclear Medicine, The Second People’s Hospital of Yibin, Yibin, China
| | - Xiaoai Wu
- Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China,Xiaoai Wu,
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Hong Fan,
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13
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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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14
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Curcean A, Curcean S, Rescigno P, Dafydd DA, Tree A, Reid A, Koh DM, Sohaib A, Tunariu N, Shur J. Imaging features of the evolving patterns of metastatic prostate cancer. Clin Radiol 2021; 77:88-95. [PMID: 34598790 DOI: 10.1016/j.crad.2021.09.005] [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] [Received: 11/02/2020] [Accepted: 09/02/2021] [Indexed: 12/28/2022]
Abstract
The pattern of metastases in prostate cancer (PC) is evolving. Increased use of imaging, newer imaging techniques with higher sensitivity for disease detection and patients receiving multiple lines of novel therapies with increased life expectancy are likely to be contributory. Awareness of metastatic disease patterns improves early diagnosis, accurate staging, and initiation of appropriate therapy, and can inform prognostic information and anticipate potential disease complications. The aim of this review is to document the spectrum of metastases in PC including emerging and unusual patterns, and to highlight the role of novel imaging including prostate-specific membrane antigen (PSMA)-positron-emission tomography (PET) and whole-body magnetic resonance imaging (WB-MRI) to improve diagnostic and response assessment accuracy.
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Affiliation(s)
- A Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - S Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - P Rescigno
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - D Ap Dafydd
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - A Tree
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - A Reid
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - D-M Koh
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - A Sohaib
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - N Tunariu
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - J Shur
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK.
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15
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Shahrokhi P, Masteri Farahani A, Tamaddondar M, Rezazadeh F. The utility of radiolabeled PSMA ligands for tumor imaging. Chem Biol Drug Des 2021; 99:136-161. [PMID: 34472217 DOI: 10.1111/cbdd.13946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023]
Abstract
Prostate-specific membrane antigen (PSMA) is a glycosylated type-II transmembrane protein expressed in prostatic tissue and significantly overexpressed in several prostate cancer cells. Despite its name, PSMA has also been reported to be overexpressed in endothelial cells of benign and malignant non-prostate disease. So its clinical use was extended to detection, staging, and therapy of various tumor types. Recently small molecules targeting PSMA have been developed as imaging probes for diagnosis of several malignancies. Preliminary studies are emerging improved diagnostic sensitivity and specificity of PSMA imaging, leading to a change in patient management. In this review, we evaluated the first preclinical and clinical studies on PSMA ligands resulting future perspectives radiolabeled PSMA in staging and molecular characterization, based on histopathologic examinations of PSMA expression.
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Affiliation(s)
- Pejman Shahrokhi
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Arezou Masteri Farahani
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Mohammad Tamaddondar
- Nephrology Department, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Farzaneh Rezazadeh
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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16
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Hernes E, Revheim ME, Hole KH, Tulipan AJ, Strømme H, Lilleby W, Seierstad T. Prostate-Specific Membrane Antigen PET for Assessment of Primary and Recurrent Prostate Cancer with Histopathology as Reference Standard: A Systematic Review and Meta-Analysis. PET Clin 2021; 16:147-165. [PMID: 33648661 DOI: 10.1016/j.cpet.2020.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prostate-specific membrane antigen PET is a promising diagnostic tool in prostate cancer. The gold standard for the detection of prostate tumor and lymph node metastases is histopathology. The aim of the present review was to investigate accuracy measures of 68Ga/18F-labeled prostate-specific membrane antigen PET tracers in primary and recurrent prostate cancer with systematic sector-based histopathology as the reference standard. A systematic literature search was performed and 34 studies were included. Overall, prostate-specific membrane antigen PET showed high specificity, but variable sensitivity to localize known prostate cancer and detect pelvic lymph node metastases.
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Affiliation(s)
- Eivor Hernes
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway.
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Knut Håkon Hole
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Andreas Julius Tulipan
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
| | - Wolfgang Lilleby
- Department of Oncology, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424 Oslo, Norway
| | - Therese Seierstad
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
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17
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Liu H, Liu Y, Chen Y, Liu H. 68Ga-PSMA Uptake in Pulmonary Tuberculosis: A Pitfall in Prostate Cancer PET Imaging. Nuklearmedizin 2020; 60:252-253. [PMID: 33302315 DOI: 10.1055/a-1312-6148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Huijuan Liu
- Department of Intensive Care Unit, Jiangan Hospital of Traditional Chinese Medicine, Yibin, Sichuan, PR China, Yibin, China
| | - Yuhong Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University/Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, PR China, Luzhou, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University/Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, PR China, Luzhou, China
| | - Huipan Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University/Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, PR China, Luzhou, China
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18
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Farolfi A, Hirmas N, Gafita A, Weber M, Barbato F, Wetter A, Mei R, Pianori D, Hadaschik B, Herrmann K, Castellucci P, Fanti S, Eiber M, Fendler WP. Identification of PCWG3 Target Populations Is More Accurate and Reproducible with PSMA PET Than with Conventional Imaging: A Multicenter Retrospective Study. J Nucl Med 2020; 62:675-678. [DOI: 10.2967/jnumed.120.246603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022] Open
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19
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Impact of PSMA PET/CT in prostate cancer patient’s clinical management: a pictorial essay of interesting cases with histologic confirmation. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00372-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Abstract
A 63-year-old man, recently diagnosed with carcinoma of the prostate (Gleason's score 4+4), with serum prostate-specific antigen 189.2 ng/mL, underwent Ga PSMA PET/CT scan for pretreatment staging. The study revealed abnormal tracer uptake in the prostatic bed region, the pelvic, abdominal, and mediastinal lymph nodes and diffuse metastases to the bilateral lungs. The lung metastasis was proved to be metastatic adenocarcinoma from analysis of bronchoalveolar lavage.
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21
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Toriihara A, Nobashi T, Baratto L, Duan H, Moradi F, Park S, Hatami N, Aparici CM, Davidzon G, Iagaru A. Comparison of 3 Interpretation Criteria for 68Ga-PSMA11 PET Based on Inter- and Intrareader Agreement. J Nucl Med 2019; 61:533-539. [PMID: 31562226 DOI: 10.2967/jnumed.119.232504] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/27/2019] [Indexed: 11/16/2022] Open
Abstract
PET using radiolabeled prostate-specific membrane antigen (PSMA) is now being more widely adopted as a valuable tool to evaluate patients with prostate cancer (PC). Recently, 3 different criteria for interpretation of PSMA PET were published: the European Association of Nuclear Medicine (EANM) criteria, the Prostate Cancer Molecular Imaging Standardized Evaluation criteria, and the PSMA Reporting and Data System. We compared these 3 criteria in terms of interreader, intrareader, and intercriteria agreement. Methods: Data from 104 patients prospectively enrolled in research protocols at our institution were retrospectively reviewed. The cohort consisted of 2 groups: 47 patients (mean age, 64.2 y old) who underwent Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)] (68Ga-PSMA11) PET/MRI for initial staging of biopsy-proven intermediate- or high-risk PC, and 57 patients (mean age, 70.5 y old) who underwent 68Ga-PSMA11 PET/CT because of biochemically recurrent PC. Three nuclear medicine physicians independently evaluated all 68Ga-PSMA11 PET/MRI and PET/CT studies according to the 3 interpretation criteria. Two of them reevaluated all studies 6 mo later in the same manner and masked to the initial reading. The Gwet agreement coefficient was calculated to evaluate interreader, intrareader, and intercriteria agreement based on the following sites: local lesion (primary tumor or prostate bed after radical prostatectomy), lymph node metastases, and other metastases. Results: In the PET/MRI group, interreader, intrareader, and intercriteria agreement ranged from substantial to almost perfect for any site according to all 3 criteria. In the PET/CT group, interreader agreement ranged from substantial to almost perfect except for judgment of distant metastases based on the PSMA Reporting and Data System (Gwet agreement coefficient, 0.57; moderate agreement), in which the most frequent cause of disagreement was lung nodules. Intrareader agreement ranged from substantial to almost perfect for any site according to all 3 criteria. Intercriteria agreement for each site was also substantial to almost perfect. Conclusion: Although the 3 published criteria have good interreader and intrareader reproducibility in evaluating 68Ga-PSMA11 PET, there are some factors causing interreader disagreement. Further work is needed to address this issue.
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Affiliation(s)
- Akira Toriihara
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Tomomi Nobashi
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Lucia Baratto
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Heying Duan
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Farshad Moradi
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Sonya Park
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Negin Hatami
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Carina Mari Aparici
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Guido Davidzon
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
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22
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Sheikhbahaei S, Werner RA, Solnes LB, Pienta KJ, Pomper MG, Gorin MA, Rowe SP. Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer: An Update on Important Pitfalls. Semin Nucl Med 2019; 49:255-270. [DOI: 10.1053/j.semnuclmed.2019.02.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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23
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Hu J, Zhang K, Yan Y, Zang Y, Wang Y, Xue F. Diagnostic accuracy of preoperative 18F-FDG PET or PET/CT in detecting pelvic and para-aortic lymph node metastasis in patients with endometrial cancer: a systematic review and meta-analysis. Arch Gynecol Obstet 2019; 300:519-529. [DOI: 10.1007/s00404-019-05207-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/30/2019] [Indexed: 01/01/2023]
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24
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Prostate Cancer Pulmonary Metastasis Presenting as a Ground-Glass Pulmonary Nodule on 68Ga-PSMA-11 PET/CT. Clin Nucl Med 2019; 44:e353-e356. [PMID: 30789399 DOI: 10.1097/rlu.0000000000002499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Ga-prostate-specific membrane antigen 11 (PSMA) PET/CT imaging accurately depicts metastatic prostate adenocarcinoma (PCa). Pulmonary metastases of PCa are often overlooked on follow-up imaging in patients after initial treatment and following androgen deprivation therapy. Here we present a rare case of biopsy-proven PCa pulmonary metastasis with a ground-glass appearance. The increased PSMA expression and the evolving CT features of the solid component of the ground-glass nodule detected by PSMA PET/CT imaging led to surgical resection and PET/CT-guided therapy.
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25
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Prostate-Specific Membrane Antigen-Positive Manifestations of Chronic Beryllium Lung Disease. Clin Nucl Med 2019; 44:64-65. [PMID: 30358624 DOI: 10.1097/rlu.0000000000002323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Three years after prostatectomy, a 78-year-old man with initial high-risk prostate cancer and new increasing prostate-specific antigen levels underwent Ga-prostate-specific membrane antigen (PSMA) PET/CT. Imaging revealed PSMA-positive pelvic, ascending retroperitoneal and left supraclavicular lymph nodes consistent with metastases. Additionally, there was PSMA-positive lymphadenopathy (hilar and mediastinal) and pulmonary changes (fibrotic and nodular) in which histopathology excluded metastases. A lymphocyte proliferation test was indicative of beryllium sensitization. Chronic beryllium lung disease-a multisystem granulomatous inflammatory disease mainly affecting the lungs-could be established in this patient with occupational exposure to beryllium. This case shows that manifestations of berylliosis can also be PSMA positive.
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