Clinical perspectives of PSMA PET/MRI for prostate cancer

Barbosa, Felipe de Galiza; Queiroz, Marcelo A.; Nunes, Rafael Fernandes; Marin, José Flávio Gomes; Buchpiguel, Carlos Alberto; Cerri, Giovanni Guido

doi:10.6061/clinics/2018/e586s

Cited by 23 publications

(25 citation statements)

References 74 publications

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“…The diagnostic image of the primary tumor in prostate cancer is still waiting for his white knight. At present, mpMRI is the imaging modality of choice for precise morphologic evaluation, has higher spatial resolution, and provides clearer anatomic delineation of the prostate and surrounding anatomical structures than PET, while PSMA PET is the superior modality for detecting metastases to the locoregional and extrapelvic lymph nodes, bones, and visceral organs [33]. More than 90% of primary PCa lesions show moderate to high PSMA expression levels on PSMA PET, and many current studies have indicated that PET/MRI could be the single ideal imaging modality for staging PCa patients [33].…”

Section: Discussionmentioning

confidence: 99%

“…At present, mpMRI is the imaging modality of choice for precise morphologic evaluation, has higher spatial resolution, and provides clearer anatomic delineation of the prostate and surrounding anatomical structures than PET, while PSMA PET is the superior modality for detecting metastases to the locoregional and extrapelvic lymph nodes, bones, and visceral organs [33]. More than 90% of primary PCa lesions show moderate to high PSMA expression levels on PSMA PET, and many current studies have indicated that PET/MRI could be the single ideal imaging modality for staging PCa patients [33]. Several studies have demonstrated that the intensity of radiotracer accumulation in the primary tumor is correlated to PSA levels and Gleason score and therefore with PCa groups of risk [34,35].…”

Section: Discussionmentioning

confidence: 99%

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Pilot performance of a dedicated prostate PET suitable for diagnosis and biopsy guidance

et al. 2020

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Background: Prostate cancer (PCa) represents one of the most common types of cancers facing the male population. Nowadays, to confirm PCa, systematic or multiparametric MRI-targeted transrectal or transperineal biopsies of the prostate are required. However, due to the lack of an accurate imaging technique capable to precisely locate cancerous cells in the prostate, ultrasound biopsies sample random parts of the prostate and, therefore, it is possible to miss regions where those cancerous cells are present. In spite of the improvement with multiparametric MRI, the low reproducibility of its reading undermines the specificity of the method. Recent development of prostatespecific radiotracers has grown the interest on using positron emission tomography (PET) scanners for this purpose, but technological improvements are still required (current scanners have resolutions in the range of 4-5 mm). Results: The main goal of this work is to improve state-of-the-art PCa imaging and diagnosis. We have focused our efforts on the design of a novel prostate-dedicated PET scanner, named ProsPET. This system has small scanner dimensions defined by a ring of just 41 cm inner diameter. In this work, we report the design, implementation, and evaluation (both through simulations and real data) of the ProsPET scanner. We have been able to achieve < 2 mm resolution in reconstructed images and high sensitivity. In addition, we have included a comparison with the Philips Gemini-TF scanner, which is used for routine imaging of PCa patients. The ProsPET exhibits better contrast, especially for rod sizes as small as 4.5 mm in diameter. Finally, we also show the first reconstructed image of a PCa patient acquired with the ProsPET. Conclusions: We have designed and built a prostate specific PET system, with a small footprint and improved spatial resolution when compared to conventional whole-body PET scanners. The gamma ray impact within each detector block includes accurate DOI determination, correcting for the parallax error. The potential role of combined organdedicated prostate-specific membrane antigen (PSMA) PET and ultrasound devices, as a prebiopsy diagnostic tool, could be used to guide sampling of the most aggressive sites in the prostate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pilot performance of a dedicated prostate PET suitable for diagnosis and biopsy guidance

et al. 2020

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“…PSMA PET/magnetic resonance imaging (MRI) is a hybrid imaging technique that combines the morphological information of MRI with the molecular data of PET. MRI provides excellent anatomical characterization and soft tissue contrast, whereas PSMA PET offers a reliable molecular characterization of the tumor[ 7 ]. The first applications of PSMA PET/MRI in the PCa setting were described in 2013[ 8 ]; since that time, several papers reported the potential applications of this imaging modality in different clinical scenarios[ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

New frontiers in focal therapy for prostate cancer: Prostate-specific membrane antigen positron emission tomography/magnetic resonance imaging

Manfredi¹,

Fernández-Pascual²,

Linares-Espinós³

et al. 2021

WJCO

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Imaging has a central role in the context of focal therapy (FT) for prostate cancer (PCa). Prostate-specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel imaging modality that combines the morpho-functional information of MRI with the molecular characterization of PET . Some papers reported the potential advantages of PSMA PET/MRI in different clinical scenarios. Limited evidence on PSMA PET/MRI is available in the setting of FT. PSMA PET/MRI can be an effective imaging modality for detecting primary PCa and seems to provide accurate local staging of primary PCa. PSMA PET/MRI also shows high performance for restaging and detecting tumor recurrence. The higher soft-tissue contrast and the reduction of ionizing radiation are the main advantages reported in the literature compared to PET/computed tomography. PSMA PET/MRI could represent a turning point in the management of patients with PCa in the context of FT. Further studies are needed to confirm its applications in this specific clinical setting.

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“…8 Though the exact functions of PSMA are yet to be defined, it is still used for staging and treatment due to its high multiplication in PCa. 8,9 Many other malignancies, namely breast cancer, colorectal carcinoma, follicular lymphoma, etc., also express PSMA with 68 Ga-PSMA avidness. Highly expressed PSMA (type-II-transmembrane glycoprotein) is also observed in almost all PCa cells, except the 5-10% of PCa cells without PSMA expression.…”

Section: Introductionmentioning

confidence: 99%

Impact of the 68Ga Prostate-Specific Membrane Antigen (68Ga-PSMA) PET/CT on the Management of Prostate Cancer

Gurunath¹,

Salunke²,

Komittishetty³

2020

Journal of Exploratory Research in Pharmacology

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This review discusses the efficiency and sensitivity of 68 Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) imaging in comparison to other radiotracers and imaging techniques. It also conveys its impact on the treatment or management of prostate cancer patients. PSMA, observed in almost all prostate cancer cells, is used for staging and treatment, due to its high multiplication in this cancer when compared to normal tissues. PSMA PET/magnetic resonance imaging (MRI) has applications in the management of prostate cancer. Though PSMA PET/MRI has yielded preliminary results, it is still studied as an imaging biomarker for tumor responses. PSMA-PET/CT is known for its highly sensitive resolution, as it lights up only the parts harboring prostate cancer or tumor cells and not any other kind of lesion. Therefore, 68 Ga-PSMA-PET imaging is chosen over other variants of 68 Ga-PSMA-11, such as 177 Lu-PSMA or 225 Ac-PSMA, and it is used for its greater ability to detect metastatic sites in patients with biochemical recurrence and low serum prostate-specific antigens values. The efficacy of 68 Ga-PSMA PET/CT also allows for estimation of oligometastases, as it supports the design of therapeutic trials in measuring long-term effects in patients. Finally, 68 Ga-PSMA PET/ CT is effective in identifying recurrence localization and, hence, permits the ability to choose the best therapeutic strategy as early as possible.

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Clinical perspectives of PSMA PET/MRI for prostate cancer

Cited by 23 publications

References 74 publications

Pilot performance of a dedicated prostate PET suitable for diagnosis and biopsy guidance

Pilot performance of a dedicated prostate PET suitable for diagnosis and biopsy guidance

New frontiers in focal therapy for prostate cancer: Prostate-specific membrane antigen positron emission tomography/magnetic resonance imaging

Impact of the 68Ga Prostate-Specific Membrane Antigen (68Ga-PSMA) PET/CT on the Management of Prostate Cancer

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