[18F]-FDHT PET for the Imaging of Androgen Receptor in Prostate and Breast Cancer: A Systematic Review

Abstract

The aim of this systematic review is to provide a comprehensive overview of the role of fluoro-5α-dihydrotestosterone ([18F]-FDHT) for the in vivo imaging of androgen receptors (AR) through positron emission tomography (PET) in metastatic breast (mBC) and metastatic castration-resistant prostate cancer (mCRPC). Relevant studies published from 2013 up to May 2023 were selected by searching Scopus, PubMed and Web of Science. The selected imaging studies were analyzed using a modified version of the critical Appraisal Skills Programme (CASP). Eleven studies encompassing 321 patients were selected. Seven of the eleven selected papers included 266 subjects (82.2%) affected by mCRPC, while four encompassed 55 (17.2%) patients affected by mBC. [18F]-FDHT PET showed a satisfying test/retest reproducibility, and when compared to a histochemical analysis, it provided encouraging results for in vivo AR quantification both in mCRPC and mBC. [18F]-FDHT PET had a prognostic relevance in mCRPC patients submitted to AR-targeted therapy, while a clear association between [18F]-FDHT uptake and the bicalutamide response was not observed in women affected by AR-positive mBC. Further studies are needed to better define the role of [18F]-FDHT PET, alone or in combination with other tracers (i.e., [18F]-FDG/[18F]-FES), for patients’ selection and monitoring during AR-targeted therapy, especially in the case of mBC.

Molecular Imaging of Steroid Receptors in Breast Cancer

“…AR is a steroid receptor expressed in various tissues in males and females, including the breasts, and has important implications in prostate and breast cancer 146–148 . AR is abundantly expressed in breast cancer—approximately 70% of all primary breast cancers, 75% to 95% in ER-positive disease, and 10% to 35% in triple-negative (ER-negative, PR-negative, and HER2-negative) disease demonstrate AR positivity 146,149–152 .…”

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

“…Furthermore, a complementary evaluation with other available radiotracers, including historical PCa radiotracers (i.e., [ 18 F]F-choline and [ 18 F]F-Fluciclovine) may be helpful in challenging cases [34][35][36]. Hopefully, the availability of new radiotracers currently under experimental examination, such as [ 18 F]F-FDHT, may also contribute as an additional resource available for the future [37]. To overcome the limitation of UBU when PSMA-based PET images are interpreted, we suggest considering the clinical history of the patients, previous traumatic accidents, as well as CT characteristics.…”