Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

Shaygan, Bobby; Zukotynski, Katherine; Bénard, François; Ménard, Cynthia; Sistani, Golmehr; Veit-Haibach, Patrick; Metser, Ur

doi:10.5489/cuaj.7268

Cited by 17 publications

(19 citation statements)

References 50 publications

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“…PSMA also known as glutamate carboxypeptidase II, is a transmembrane glycoprotein highly expressed in prostate cancer cells. PSMA expression tends to increase with increased pathological Gleason grade and is thought to be upregulated with the emergence of androgen independence (6). An example of a PC patient imaged at the same time period with various tracers is illustrated in Figure 1.…”

Section: Spectrum Of Pet Radiopharmaca In Pcmentioning

confidence: 99%

PSMA PET in Imaging Prostate Cancer

Tsechelidis¹,

Vrachimis²

2022

Front. Oncol.

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After prostate malignancy diagnosis, precise determination of disease extent are fundamental steps for tailored made therapy. The earlier the diagnosis of the burden of the disease, the longer the survival in many cases. National and international guidelines are based on “classic” imaging technics combining radiological and nuclear medicine scans like CT, MRI and bone scintigraphy (BS). The most recent nuclear medicine development is the prostate specific membrane antigen (PSMA) PET and is emerging as the most promising tool of medical imaging, gaining ground every day. Nevertheless, the different onset among multiple studies fails to establish a worldwide admission and incorporation of this technique in guidelines and its position in workaday medical algorithms. It seems that the medical community agrees not to utilize PSMA PET for low-risk patients; intense debate and research is ongoing for its utility in intermediate risk patients. Contrariwise, in high-risk patients PSMA PET is confirmed outperforming CT and BS combined. Additionally, irrespectively to their castration status, patients with biochemical failure should be referred for PSMA PET. Even though PSMA PET reveals more extended disease than expected or exonerates equivalent lesions, thus impacting treatment optimization. Studies being in progress and future trials with clarify whether PSMA PET will be the new gold standard technic for specific groups of patients.

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Section: Spectrum Of Pet Radiopharmaca In Pcmentioning

confidence: 99%

PSMA PET in Imaging Prostate Cancer

Tsechelidis¹,

Vrachimis²

2022

Front. Oncol.

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“…PSMA-targeted imaging and therapy are poised to play key roles in the management of prostate cancer. Evaluation of their clinical utility will require high-level evidence from prospective clinical studies ( 101 ). Precision medicine principles guided by theranostics should be incorporated in the design of these trials, and will require collaboration across radiology/nuclear medicine, urology, medical and radiation oncology.…”

Section: Multidisciplinary Opportunities and Challenges In The Era Of Psma-targeted Prostate Cancer Managementmentioning

confidence: 99%

Incorporating PSMA-Targeting Theranostics Into Personalized Prostate Cancer Treatment: a Multidisciplinary Perspective

Gào

Salari

et al. 2021

Front. Oncol.

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Recent developments in prostate-specific membrane antigen (PSMA) targeted diagnostic imaging and therapeutics (theranostics) promise to advance the management of primary, biochemically recurrent, and metastatic prostate cancer. In order to maximize the clinical impact of PSMA-targeted theranostics, a coordinated approach between the clinical stakeholders involved in prostate cancer management is required. Here, we present a vision for multidisciplinary use of PSMA theranostics from the viewpoints of nuclear radiology, medical oncology, urology, and radiation oncology. We review the currently available and forthcoming PSMA-based imaging and therapeutics and examine current and potential impacts on prostate cancer management from early localized disease to advanced treatment-refractory disease. Finally, we highlight the clinical and research opportunities related to PSMA-targeted theranostics and describe the importance of multidisciplinary collaboration in this space.

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“…However, some malignancies, particularly prostatic adenocarcinoma and primary neuroendocrine malignancies, have been shown to have low [ 18 F]FDG-avidity [9][10][11][12]. Radiolabeled somatostatin-analogues, (e.g., 68 Gadodecane tetraacetic acid-octreotate, also known as 68 Ga-DOTATATE) [13] and radiolabeled prostatespeci c membrane antigen (PSMA) ligands, (e.g., 68 Ga-PSMA-11 and 18 F-PSMA-1007) [14][15] are novel groups of PET radiotracers that enable the whole-body localization of cells that overexpress somatostatin-receptors and the PSMA glycoprotein, respectively.…”

Section: Introductionmentioning

confidence: 99%

PET radiotracers for whole-body in-vivo molecular imaging of prostatic neuroendocrine malignancies: A case series and review of literature

Cohen

Krauthammer

Fahoum

et al. 2022

Preprint

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BackgroundNeuroendocrine malignancies of the prostate represent a spectrum of diseases. Treatment-induced neuroendocrine differentiation (tiNED) in hormonally treated adenocarcinoma has been the subject of a large amount of recent research. However, the identification of neuroendocrine features in treatment-naïve prostatic tumor raises a differential diagnosis between prostatic adenocarcinoma with de-novo neuroendocrine differentiation (dNED) versus one of the primary prostatic neuroendocrine carcinomas (P-NEC). This case series focuses on the recent advances made in the field of whole-body in-vivo molecular imaging of patients with prostatic neuroendocrine malignancies, using the PET-CT technology. While [18F]FDG is being used as the main PET radiotracer in oncologic imaging and reflects glucose metabolism of malignant lesions, other molecules labeled with positron-emitting isotopes, mainly somatostatin-analogues labeled with 68Ga and PSMA-ligands labeled with either 18F or 68Ga, have been extensively studied and are now routinely used in departments of nuclear medicine and molecular imaging.Case presentationWe present three cases of patients with different pathologically-proven entities within the spectrum of prostatic neuroendocrine malignancies: a patient with tiNED, a patient with dNED, and a patient with P-NEC. The patients underwent PET-CT with different radiotracers, and the molecular imaging data were helpful in guiding clinical decisions. We summarize and discuss relevant published data on each of the presented entities from clinical, biological and molecular imaging standpoints. We also provide the reader with practical recommendation regarding the preferred PET radiotracer for imaging each entity.ConclusionSeveral PET radiotracers are available to characterize and assess whole-body extent of prostatic malignancies within the neuroendocrine spectrum. Awareness to clinical, biologic and pathologic data should guide the selection of preferred PET radiotracer for imaging each entity. This review is unique being directed to basic scientists, clinicians, pathologists, radiologists and nuclear medicine physicians, representing the multidisciplinary nature of oncologic research nowadays.

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Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

Cited by 17 publications

References 50 publications

PSMA PET in Imaging Prostate Cancer

PSMA PET in Imaging Prostate Cancer

Incorporating PSMA-Targeting Theranostics Into Personalized Prostate Cancer Treatment: a Multidisciplinary Perspective

PET radiotracers for whole-body in-vivo molecular imaging of prostatic neuroendocrine malignancies: A case series and review of literature

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