Bone Metastases in Castration-Resistant Prostate Cancer: Associations between Morphologic CT Patterns, Glycolytic Activity, and Androgen Receptor Expression on PET and Overall Survival

Vargas, Hebert Alberto; Wassberg, Cecilia; Fox, Josef J.; Wibmer, Andreas G.; Goldman, Debra A.; Kuk, Deborah; Gönen, Mithat; Larson, S. M.; Morris, Michael J.; Scher, Howard I.; Hricak, Hedvig

doi:10.1148/radiol.13130625

Cited by 89 publications

(72 citation statements)

References 25 publications

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“…These changes may also affect the binding of FDHT, although no studies are available that explore this hypothesis on a molecular level. However, in a study of castration-resistant prostate cancer, investigators described different patterns of FDHT uptake in metastases to bone (27). Although 90% of the lesions in this study were positive at FDHT PET, a minority of vital metastases, as proven by their FDG avidity, did not accumulate FDHT.…”

Section: Imaging Of Receptors and Membrane Proteins Androgen Receptormentioning

confidence: 57%

“…For patients with PSA relapse after radical treatment, investigators showed that FDG PET/CT is less sensitive than choline-and acetate-based imaging methods in a systematic review (26). This tracer may have potential as a prognostic tool in the evaluation of castration-resistant metastatic prostate cancer (27,28) and as a predictor of treatment response to antiandrogenic therapy (29).…”

Section: Glucosementioning

confidence: 99%

“…This tracer may therefore be used to assess the androgen receptor status on a whole-body scale and to evaluate the prospects and efficacy of androgen receptor−directed pharmaceuticals. The quantity of FDHT accumulation may also have potential as a prognostic biomarker in castration-resistant prostate cancer (27).…”

Section: Imaging Of Receptors and Membrane Proteins Androgen Receptormentioning

confidence: 99%

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Molecular Imaging of Prostate Cancer

Wibmer¹,

Burger²,

Sala³

et al. 2016

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Prostate cancer is the most common noncutaneous malignancy among men in the Western world. The natural history and clinical course of prostate cancer are markedly diverse, ranging from small indolent intraprostatic lesions to highly aggressive disseminated disease. An understanding of this biologic heterogeneity is considered a necessary requisite in the quest for the adoption of precise and personalized management strategies. Molecular imaging offers the potential for noninvasive assessment of the biologic interactions underpinning prostate carcinogenesis. Currently, numerous molecular imaging probes are in clinical use or undergoing preclinical or clinical evaluation. These probes can be divided into those that image increased cell metabolism, those that target prostate cancer-specific membrane proteins and receptor molecules, and those that bind to the bone matrix adjacent to metastases to bone. The increased metabolism and vascular changes in prostate cancer cells can be evaluated with radiolabeled analogs of choline, acetate, glucose, amino acids, and nucleotides. The androgen receptor, prostate-specific membrane antigen, and gastrin-releasing peptide receptor (ie, bombesin) are overexpressed in prostate cancer and can be targeted by specific radiolabeled imaging probes. Because metastatic prostate cancer cells induce osteoblastic signaling pathways of adjacent bone tissue, bone-seeking radiotracers are sensitive tools for the detection of metastases to bone. Knowledge about the underlying biologic processes responsible for the phenotypes associated with the different stages of prostate cancer allows an appropriate choice of methods and helps avoid pitfalls. F-16b-fluoro5a-dihydrotestosterone, PSA = prostate-specific antigen, PSMA = prostate-specific membrane antigen

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Section: Imaging Of Receptors and Membrane Proteins Androgen Receptormentioning

confidence: 57%

Section: Glucosementioning

confidence: 99%

Section: Imaging Of Receptors and Membrane Proteins Androgen Receptormentioning

confidence: 99%

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Molecular Imaging of Prostate Cancer

Wibmer¹,

Burger²,

Sala³

et al. 2016

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“…Second, adaptation of conventional imaging modalities such as 99m Tc bone scanning and MRI may allow assessment of response and progression in bone, but broader application to centers with less technologic expertise will represent a challenge (111)(112)(113). Third, 18 F-FDG PET in metastatic castration-resistant prostate cancer is useful for following individual lesions on treatment and for determining whether there are relatively more metabolically active foci in the patient (42,91,112,114). However, whereas 18 F-FDG PET parameters at baseline correlate with survival, changes may be of limited value in predicting outcome.…”

Section: Smentioning

confidence: 99%

What Medical, Urologic, and Radiation Oncologists Want from Molecular Imaging of Prostate Cancer

Ballas

Abreu

Quinn³

2016

J Nucl Med

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As molecular imaging better delineates the state of prostate cancer, clinical management will evolve. The currently licensed imaging modalities are limited by lack of specificity or sensitivity for the extent of cancer and for predicting outcome in response to therapy. Clinicians want molecular imaging that-by being more reliable in tailoring treatment and monitoring response for each patient-will become a key facet of precision medicine, surgery, and radiation therapy. Identifying patients who are candidates for specific or novel treatments is important, but equally important is the finding that a given patient may not be a good candidate for single-modality therapy. This article presents prostate cancer scenarios in which managing clinicians would welcome molecular imaging innovations to help with decision making. The potential role of newer techniques that may help fill this wish list is discussed.

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“…16beta- 18 18 F-FDG uptake did not correlate with shorter survival (reader 1: p = 0.65; reader 2: p = 0.38). Thirty-three patients were followed until death and five patients were followed for an average of 37.5 months until death (range: 6.6-59.1 months) [54]. Thus, 18 F-FDHT use has been confined to patients with advanced PCa and has been useful in drug development, but there is no compelling evidence that it could be useful on a broader scale as most agents are positive in this advanced setting from a diagnostic perspective.…”

Section: Beta-18 F-fluoro-5alpha-dihydrotestosteronementioning

confidence: 99%

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

et al. 2016

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Early detection of recurrent prostate cancer (PCa) is of paramount importance to deliver prompt and accurate therapy reducing the chance of progression to metastatic disease. However, current imaging modalities such as conventional computed tomography, MRI and PET scanning do not provide sufficient sensitivity, especially at lower prostate-specific antigen values. Moreover, biological characterization of PCa has become increasingly important to provide patient-specific therapy and current imaging poorly characterizes disease aggressiveness. The current uprise of novel PET tracers in recurrent and metastatic PCa shows promising, yet variable sensitivities and specificities in detection, indicating the need for further studies. In this review, we highlight current and new PET tracers that have been developed to improve the detection of recurrent and metastatic PCa. KEYWORDS• biochemical recurrenceProstate cancer (PCa) is the most common noncutaneous malignancy in American men with 180,890 new cases and 26,120 deaths estimated in 2016 alone [1]. Recent advances in detection, monitoring and treatment of the disease include the growing use of multiparametric MRI, transrectal ultrasound/fusion MRI-guided biopsies and new focal therapies. Primary definitive therapy options for PCa remain radiation therapy (RT) and radical prostatectomy (RP), which are used with curative intent, although both methods have improved over time. Despite the high success rates in primary treatment, 15-25% of patients still experience biochemical recurrence (BCR), following primary definitive therapy with RP or RT [2][3][4][5][6][7]. The definition of BCR varies between therapy methods. For instance, following RP a rising PSA above 0.2 ng/ml defines BCR whereas following RT BCR is defined as a PSA change of 2.0 ng/ml above the nadir following RT and is known as the Phoenix criteria [7]. As rising PSA in post primary therapy patients is an indicator of PCa BCR, close monitoring of serum PSA levels following treatment is critical [7,8]. In the case of BCR, early detection and initiation of therapy is a key to better long-term outcomes. Early intervention is associated with a lower rate of metastatic disease. Thus, accurate and early detection of recurrence leading to earlier treatment will aid in hindering the progression of BCR to metastatic disease.Multiple imaging modalities exist for the detection of recurrent PCa including computed tomography (CT), bone scintigraphy, MRI and PET. However, the need for more sensitive and specific imaging modalities to detect early recurrent and metastatic PCa has been prompted by evidence supporting early treatment. In addition to more sensitive and specific imaging, there has been a 'thrust' toward personalized and targeted management to discover disease phenotype and predict clinical outcomes earlier, which PET/CT has answered the call [9]. The future demands more For reprint orders, please contact: reprints@futuremedicine.com

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Bone Metastases in Castration-Resistant Prostate Cancer: Associations between Morphologic CT Patterns, Glycolytic Activity, and Androgen Receptor Expression on PET and Overall Survival

Cited by 89 publications

References 25 publications

Molecular Imaging of Prostate Cancer

Molecular Imaging of Prostate Cancer

What Medical, Urologic, and Radiation Oncologists Want from Molecular Imaging of Prostate Cancer

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

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