¿Constituirán en el futuro los radioligandos de 68 Ga-PSMA la única elección de la Medicina Nuclear para el cáncer de próstata? Actualización clínica

Cuccurullo, Vincenzo; Stasio, Giuseppe Danilo Di; Evangelista, Laura; Ciarmiello, Andrea; Mansi, Luigi

doi:10.1016/j.remn.2017.10.008

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…The European Urology Association updated guidelines on PCa in 2016, stating the importance of PET with choline combined with CT to identify lymph node involvement and metastatic spread at all stages. [9] The fundamental of choline as a tracer labeled with 11 C or 18 F is that choline, as a precursor for the synthesis of phospholipids, is part of the cell membrane, whereby the upregulated of the key enzyme choline kinase in PCa cells leads to an increase in the demand for substrate (choline). Moreover, PCa cells show an upregulated transport rate with an increased expression of choline transporters.…”

Section: Introductionmentioning

confidence: 99%

Direct comparison of choline PET/CT and MRI in the diagnosis of lymph node metastases in patients with prostate cancer

Huang

Yin²,

Yue³

et al. 2018

Medicine

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Background:Lymph node detection in prostate cancer is challenging and critical to determine treatment policy. Choline PET/CT (positron emission tomography/computed tomography) and magnetic resonance imaging (MRI) have been used for the evaluation of lymph node metastasis in patients with prostate cancer for the past decade. However, only limited patients underwent direct comparison studies.Purpose:To evaluate the diagnostic performance of choline PET/CT compared with MRI imaging for detecting lymph node metastases in prostate cancer patients.Material and Methods:Relevant English-language articles published before February 2018 were searched in PubMed database, Embase database, and Cochrane Library databases search using the keywords: (Prostate Neoplasm OR Prostate Cancer OR prostate carcinoma) and (Lymph Node) and (PET/CT OR positron emission tomography/computed tomography) and (choline or 2-hydroxy-N,N,N-trimethylethanaminium) and (magnetic resonance imaging OR MRI). Articles were included that directly compare the diagnostic performance and clinical utility of choline PET/CT and MRI for detecting lymph node metastases in prostate cancer patients. Study quality was assessed with QUADAS criteria. Analyses were performed on a per patient and a per node basis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (LR+), and negative likelihood ratio (LR−) were calculated using Meta-Disc 1.4 software. Summary receiver-operating characteristic (SROC) curves constructed.Results:A total of 362 patients from 8 studies involving fulfilled the inclusion criteria. On patient-based analysis, the pooled sensitivity, specificity, and DOR with a 95% confidence interval (CI) for choline PET/CT imaging were 0.59 (95%CI, 0.50–0.67), 0.92 (95%CI, 0.87–0.96), 17.37 (95%CI, 4.42–68.33), and for MRI imaging, they were 0.52 (95%CI, 0.44–0.61), 0.87 (95%CI, 0.81–0.92), 6.05 (95%CI, 3.09–11.85), respectively. On node-based, the corresponding values for choline PET/CT imaging were 0.51 (95%CI, 0.46–0.57), 0.99 (95%CI, 0.98–0.99), 65.55 (95%CI, 23.55–182.45), and for MRI imaging, they were 0.39 (95%CI, 0.34–0.44), 0.97 (95%CI, 0.96–0.97), 15.86 (95%CI, 8.96–28.05), respectively.Conclusion:Choline PET/CT performed better than MRI imaging in evaluating the lymph nodes metastasis of prostate cancer patients and had the potential to be broadly applied in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Direct comparison of choline PET/CT and MRI in the diagnosis of lymph node metastases in patients with prostate cancer

Huang

Yin²,

Yue³

et al. 2018

Medicine

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Prostate-Specific Membrane Antigen as Target for Neuroimaging of Central Nervous System Tumors

et al. 2022

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Introduction. Positron emission tomography (PET) imaging with prostate-specific membrane antigen- (PSMA-) binding tracers has been found incidentally to demonstrate uptake in CNS tumors. Following the encouraging findings of several such case reports, there is a growing interest in the potential application of PSMA-targeted PET imaging for diagnostics, theranostics, and monitoring of CNS tumors. This is a systematic literature review on PSMA-binding tracers in CNS tumors. Methods. A PubMed search was conducted, including preclinical and clinical reports. One hundred and twelve records were identified, and after screening, 56 were included in the final report. Results. Tissue studies demonstrated PSMA expression in tumor vascular endothelial cells, without expression in normal brain tissue, though the extent and intensity of staining varied by anti-PSMA antibody and methodology. Most included studies reported on gliomas, which showed strong PSMA ligand uptake and more favorable tumor to background ratios than other PET tracers. There are also case reports demonstrating PSMA ligand uptake in prostate cancer brain metastases, nonprostate cancer brain metastases, and meningiomas. We also review the properties of the various PSMA-binding radiotracers available. Therapeutic and theranostic applications of PSMA-binding tracers have been studied, including labeled alpha- and beta-ray emitting isotopes, as well as PSMA targeting in directing MRI-guided focused ultrasound. Conclusions. There is a potential application for PSMA-targeted PET in neuro-oncology as a combination of diagnostic and therapeutic use, as a theranostic modality for managing CNS tumors. Further research is needed regarding the mechanism(s) of PSMA expression in CNS tumors and its differential performance by tumor type.

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Performance of 68Ga-labeled prostate-specific membrane antigen ligand positron emission tomography/computed tomography in the diagnosis of primary prostate cancer: a systematic review and meta-analysis

Yang

et al. 2022

Int. braz j urol.

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Objective: To explore the feasibility of 68 Ga-PSMA PET/CT in diagnosing primary prostate cancer. Materials and Methods: Embase, PubMed and Cochrane Library databases were searched for studies published before July 2020. The studies that used 68 Ga-PSMA PET/CT for detecting primary prostate cancer, and pathological biopsy as the reference standard were included. The selecting process used preferred reporting items for systematic reviews and meta-analyses (PRISMA). The quality of enrolled studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results: According to our search strategy, 9 studies were included for analysis. A total of 547 patients with primary prostate cancer and 443 lesion segments that underwent 68 Ga-PSMA PET/CT scans were included and their pathological biopsies were compared. The results of these studies showed some differences. For instance, the lowest sensitivity of 68 Ga-PSMA PET/CT in diagnosing primary prostate cancer was 67%, while the highest sensitivity recorded was 97%. Conclusions: Compared with conventional imaging examinations, 68 Ga-PSMA PET/CT had higher sensitivity and specificity in detecting primary prostate cancer. At present, most of the studies that used 68 Ga-PSMA PET/CT for detecting prostate cancer are retrospective studies. Based on its advantage of high detection rate, the use of 68 Ga-PSMA PET/CT in the detection of primary prostate cancer is worthy of promotion.

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¿Constituirán en el futuro los radioligandos de 68 Ga-PSMA la única elección de la Medicina Nuclear para el cáncer de próstata? Actualización clínica

Cited by 3 publications

References 29 publications

Direct comparison of choline PET/CT and MRI in the diagnosis of lymph node metastases in patients with prostate cancer

Direct comparison of choline PET/CT and MRI in the diagnosis of lymph node metastases in patients with prostate cancer

Prostate-Specific Membrane Antigen as Target for Neuroimaging of Central Nervous System Tumors

Performance of 68Ga-labeled prostate-specific membrane antigen ligand positron emission tomography/computed tomography in the diagnosis of primary prostate cancer: a systematic review and meta-analysis

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