Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labelled PSMA ligand for the diagnosis of recurrent prostate cancer: initial experience

Afshar‐Oromieh, Ali; Haberkorn, Uwe; Schlemmer, HP; Fenchel, Michael; Eder, Matthias; Eisenhut, Michael; Hadaschik, Boris; Kopp‐Schneider, Annette; Röthke, Matthias

doi:10.1007/s00259-013-2660-z

Cited by 291 publications

(208 citation statements)

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“…in which the authors were able to show that Ga-68-labeled PSMA can also be used for MR-PET diagnostic imaging as an interesting tracer with the possibility for simple and accurate detection [64,65]. In a case report regarding Ga-68-PSMA MR-PET, Eiber et al show the advantages of the additional information provided by multiparametric MRI based on the example of diffusion restriction for the differentiation of postinterventional changes and tumor manifestations in the primary diagnosis of PCa after biopsy [66]. A comparison study between MR-PET and PET/CT using the new tracer Ga-68-PSMA including 20 PCa patients showed easier and better lesion detection with MR-PET 3 h p. i. than with PET/CT 1 h p. i.…”

Section: Gamentioning

confidence: 99%

Nuclear Medicine Imaging of Prostate Cancer

Schreiter

Reimann

Geisel

et al. 2016

Fortschr Röntgenstr

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The new tracer Gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) yields new promising options for the PET/CT diagnosis of?prostate cancer (PCa) and its metastases. To?overcome limitations of hybrid imaging, known from the use of choline derivatives, seems to be possible with the use of Ga-68 PSMA for PCa. The benefits of hybrid imaging with Ga-68 PSMA for PCa compared to choline derivatives shall be discussed in this article based on an overview of the current literature. Key Points: ??Ga-68 PSMA PET/CT can achieve higher detection rates of PCa lesions than PET/CT performed with choline derivatives ??The new tracer Ga-68 PSMA has the advantage of high specificity, independence of PSA-level and low nonspecific tracer uptake in surrounding tissue ??The new tracer Ga-68 PSMA seems very suitable for MR-PET diagnostic Citation Format: ??Schreiter V, Reimann C, Geisel D et?al. Nuclear Medicine Imaging of Prostate Cancer. Fortschr R?ntgenstr 2016; 188: 1037???1044

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Section: Gamentioning

confidence: 99%

Nuclear Medicine Imaging of Prostate Cancer

Schreiter

Reimann

Geisel

et al. 2016

Fortschr Röntgenstr

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“…For example, ligands for prostate-specific membrane antigen and gastrin-releasing peptide receptors were recently demonstrated by several investigators to provide high-contrast images of primary and metastatic prostate cancers in patients (17)(18)(19)(20)(21). Combined with multiparametric MR imaging, these new imaging probes may be used to differentiate prostate cancer from benign diseases of the prostate, to characterize the aggressiveness of primary prostate cancer, and to localize recurrent disease in patients with biochemical recurrence.…”

Section: Limited Number Of Overlapping Clinical Indications For 18 F-mentioning

confidence: 99%

PET/MR Imaging: A Critical Appraisal

Weber

2014

J Nucl Med

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Despite considerable excitement about the potential of PET/MR imaging for the detection, staging, and functional characterization of cancer, this new technology is evolving significantly more slowly than PET/CT. This slower evolution is due partly to ongoing technologic challenges (e.g., accurate attenuation correction of PET images) but also to the complex logistics of combining a whole-body PET scan with whole-body or organ-specific MR imaging. Most PET/MR imaging research published so far has focused on cancer staging and restaging in patients undergoing 18 F-FDG PET/CT as the standard of care. These studies have demonstrated the feasibility of clinical 18 F-FDG PET/MR imaging but so far have not shown substantial improvements in staging. This situation may not be unexpected in view of the fact that MR imaging has not replaced CT for staging of the malignancies for which 18 F-FDG PET/CT is most commonly used. Given the widespread concerns about rising health care costs in general and the costs of advanced imaging techniques in particular, establishing 18 F-FDG PET/MR imaging for whole-body cancer staging may be challenging because it requires more expensive equipment and longer acquisition times than 18 F-FDG PET/CT. An alternative approach to developing clinical PET/MR imaging is to study how stand-alone, organ-specific MR imaging can be improved by PET/MR imaging. Unfortunately, however, 18 F-FDG PET has significant limitations for the tumors that are most commonly studied with MR imaging (brain, liver, pancreatic, and prostate tumors). However, this situation may change with the development of new radiopharmaceuticals, such as prostate-specific membrane or gastrin-releasing peptide receptor ligands for the imaging of prostate cancer. In conclusion, PET/MR imaging has many potential advantages over PET/CT (lower radiation exposure, higher soft-tissue contrast, and multiparametric imaging). Realizing this potential in clinics likely will require new radiopharmaceuticals and applications other than whole-body cancer staging.

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“…Research, notably at the preclinical level, on new radiopharmaceuticals for the detection of prostate cancer has been ongoing in recent years. Recently, the first promising clinical results with bombesin [22][23][24] and PSMA ligand [25][26][27] analogues have been reported. These two tracers are among the top currently investigated tracers that recognize gastrin-releasing peptides (GRP) and the PSMA receptors identified in large amount and in a high percentage of prostate cancers.…”

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PET/CT imaging and the oligometastatic prostate cancer patient: an opportunity for a curative approach with high-dose radiotherapy?

Miralbell

Buchegger

2014

Eur J Nucl Med Mol Imaging

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Although not curative, androgen deprivation (AD) therapy is presently the first treatment option for patients with recurrent and/or metastatic prostate cancer [1]. Metastatic prostate cancer most frequently becomes resistant to continuous AD after an average treatment time of 2 -3 years [2]. Furthermore, long-term AD may induce substantial side effects in patients compromising general health status and quality of life including cognitive and sexual impairment, fatigue, cardiovascular dysfunction, metabolic syndrome, loss of lean body mass, and osteoporosis [3][4][5]. Intermittent short courses of AD have been proposed as an alternative to continuous AD and tested in several phase II/III trials with the aim of reducing the severity and duration of the above-mentioned side effects and of delaying further the clinical appearance and progression of hormone-independent disease [6,7]. However, these trials have been unable to show a survival benefit of intermittent compared to continuous AD. Nevertheless, substrata analysis from a pre-PET/CT era randomized trial (RTOG 85-31) that recruited patients between 1987 and 1992 and compared continuous AD plus radiation with radiation alone in patients with pathological node-positive adenocarcinoma of the prostate showed 5-year biochemical control (i.e. PSA <1.5 ng/ml) in 54 % of the combined treatment arm versus 33 % of the radiation-only arm [8]. The 9-year absolute survival rate was 62 % in patients treated with combined treatment [8]. In other words, patients with disease in the pelvic or paraaortic lymph node regions treated with a combination of AD and curative intent radiotherapy can expect long-term survival despite their metastatic status.A large majority of patients with early biochemical failure after treatment of their primary tumour with curative intent have no evidence of disease on standard imaging such as bone scan or abdominal CT unless the PSA increases above 20 ng/ml [9]. PET/CT tracers for prostate cancer, including 11 C-acetate, 11 C-choline and 18 F-choline, were developed more than a decade ago and their role as reliable imaging tools for assessing the extension of disease in patients with biochemical failure in an earlier stage has slowly widened [10,11]. Head-to-head comparisons of these three different tracers are relatively scarce and frequently include only small numbers of patients. We have recently shown with PET/CT that 11 C-acetate and 18 F-choline produce very similar imaging results in patients with early relapse of prostate cancer [12]. The relapse status of local, regional and distant sites can be properly assessed with these imaging techniques so that the salvage treatment approach can be optimized.An oligometastatic status is not an uncommon clinical situation in patients with disseminated prostate cancer. Indeed, Harada et al. observed a large proportion of patients with one or two metastases in an autopsy series of 136 patients: 36 % and 32 % of patients had one and two bone lesions, respectively [13] . Only 10 % of patients had four or ...

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Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labelled PSMA ligand for the diagnosis of recurrent prostate cancer: initial experience

Cited by 291 publications

References 24 publications

Nuclear Medicine Imaging of Prostate Cancer

Nuclear Medicine Imaging of Prostate Cancer

PET/MR Imaging: A Critical Appraisal

PET/CT imaging and the oligometastatic prostate cancer patient: an opportunity for a curative approach with high-dose radiotherapy?

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