Evaluation of Prostate Cancer with <sup>11</sup>C- and <sup>18</sup>F-Choline PET/CT: Diagnosis and Initial Staging

Nitsch, Sascha; Hakenberg, Oliver W.; Heuschkel, Martin; Dräger, Désirée Louisê; Hildebrandt, Guido; Krause, Bernd J.; Schwarzenböck, Sarah M.

doi:10.2967/jnumed.115.169748

Cited by 31 publications

(18 citation statements)

References 45 publications

(69 reference statements)

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“…At primary staging, the pooled sensitivity of choline PET/CT for the detection of LN metastases was low (49.2%) in a recent metaanalysis (21). The results were similar when different cholinebased agents were compared (22). The intraprostatic localization of primary disease is hampered by nonspecific uptake in benign changes (e.g., benign prostatic hyperplasia) (23).…”

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confidence: 99%

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

et al. 2017

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The prostate-specific membrane antigen (PSMA) is highly expressed on most prostate cancer (PC) cells. Therefore, the targeting of PSMA has become increasingly important over the last decade. Glu-ureabased PSMA ligands used for both imaging and radioligand therapy are the mainstays of the current success. For PET imaging, both 68 Gaand 18 F-labeled agents have been successfully translated to clinical applications. Mainly retrospective cohort studies have shown a high value in the setting of biochemical recurrence, with high detection rates even in the presence of low prostate-specific antigen levels. Preliminary data indicated that radioguided surgery with PSMA ligands may help to further improve patient outcomes because it facilitates the removal of small tumor deposits that are otherwise difficult to detect. For primary PC, PSMA ligand PET imaging has been shown to be superior to cross-sectional imaging for the detection of metastatic lymph nodes. In addition, it promises to also provide intraprostatic tumor localization, especially when used in combination with multiparametric MRI. Increasing numbers of studies have reported considerable changes in management resulting from PSMA ligand PET imaging for both biochemical recurrence and primary disease. The use of 177 Lu-PSMA-based radioligand therapy has demonstrated a reasonable response, mainly as defined by a prostate-specific antigen response of more than 50%, comparable to other recently introduced agents. Especially given the high level of safety of 177 Lu-PSMA radioligand therapy, with only minimal grade 3 and 4 toxicities reported so far, it has the potential to expand options for metastatic castrationresistant PC. This review is intended to provide a comprehensive overview of the current literature on low-molecular-weight PSMA ligands for both PET imaging and therapeutic approaches, with a focus on agents that have been clinically adopted.

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confidence: 99%

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

et al. 2017

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“…In addition to 18 F-FDG, routine clinical imaging procedures use various radiolabelled tracers [e.g., 18 F-choline, 18 F-NaF, 68 Ga-prostate-specific membrane antigen (PSMA), 68 Ga-DOTATATE, 18 F-FACBC] with demonstrated efficacy for cancer diagnosis in various clinical settings [26][27]. Newly developed tracers exhibit increased accuracy for the detection of small, incipient metastatic foci [28][29]. Improvements in MRI techniques, and particularly in functional imaging, have enabled radiologists to play an important role in the risk stratification and management of patients [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

“…Simultaneous PET/CT-guided biopsies of the prostate and other organs were performed in 57.1% (8/14) of the patients with prostatic lesions. The incidence rate of multiple primary tumours was 28.6% (4/14). The patients' characteristics are summarised in Table 1.…”

Section: Multiple Primary Tumours In Patients With Prostatic Lesionsmentioning

confidence: 99%

Positron emission tomography/computed tomography-guided percutaneous trans-pararectal space prostate biopsy for the diagnosis of prostate cancer: A retrospective study

Luo

Ruan

Pang

et al. 2020

Preprint

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Background Biopsy is considered the gold-standard technique for prostate cancer diagnosis and is recommended in patients with a high clinical indication of prostate cancer. In this study, we aimed to determine the diagnostic efficacy of a novel positron emission tomography (PET)/computed tomography (CT)-guided percutaneous trans-pararectal space-based approach to targeted prostate biopsy.Methods PET/CT-guided percutaneous trans-pararectal space prostate biopsies were performed in 14 consecutive patients with indications of prostate cancer. Whole-body 18 F-FDG PET/CT indicated the presence of 18 F-fluorodeoxyglucose (FDG)-avid focal prostate lesions. Two tissue specimens were obtained from each patient. The final diagnoses were established based on the results of a histopathological analysis and clinical follow-up, and these findings were used to verify the diagnostic accuracy of 18 F-FDG PET/CT for prostate cancer.Results The diagnostic accuracy of 18 F-FDG PET/CT for prostate cancer was 81.8%. Further analyses of the two biopsied samples per patient led to confirmed histopathological and immunohistochemical diagnoses of prostate cancer in all 14 patients. Consequently, the success rate of PET/CT-guided percutaneous trans-pararectal space prostate-targeted biopsy for the diagnosis of prostate cancer was 100.0% (14/14). Regarding safety, the average duration of biopsy was 20 min, and no serious complications occurred.Conclusions PET/CT-guided percutaneous trans-pararectal space prostate biopsy may yield a new approach to targeted prostate biopsy for the diagnosis of prostate cancer. Moreover, this biopsy procedure can be performed safely without complications, and is more cost-effective than conventional trans-rectal and trans-perineal prostate biopsy methods.

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“…None of the PET tracers are currently recommended for the primary staging and localization of PCa due to their low sensitivity and specificity. [ 7 8 ] Martorana et al . compared choline PET with sextant biopsy and concluded that the sensitivity for localization with PET/CT was reduced to 4% for nodules <5 mm as against 83% for larger nodules.…”

Section: Diagnosis Localization and T-staging Of Primary Prostate Cmentioning

confidence: 99%

“…[ 20 21 ] PET is not currently recommended for routine clinical use in nodal assessment irrespective of the risk category and is unlikely to replace PLND. [ 8 ]…”

Section: Lymph Node Stagingmentioning

confidence: 99%

Positron emission tomography in prostate cancer: An update on state of the art

2018

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Prostate cancer (PCa), one of the most common cancers in males, is a topic of active interest in imaging research. Positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance imaging (PET/MRI) have enabled the combination of morphologic and functional imaging with the promise of providing better information in guiding therapy. 18F-fluorodeoxyglucose, the workhorse radiopharmaceutical in PET imaging, has not found preference in PCa since these tumors show poor glucose uptake and can be obscured by the normal urinary excretion of the radiotracer. Hence, the last two decades have seen the development of multiple newer radiotracers and better optimization of the technical aspects of PET imaging. The combination of functional imaging and MRI holds great promise. We searched PubMed, Scopus, and Google Scholar for peer-reviewed literature concerning the advances and newer developments in the imaging of PCa between the years 2005 and 2017. This review aims at summarizing current evidence on the role of PET imaging in PCa and its impact on the diagnosis, staging, prognostication, response assessment, and restaging of this malignancy.

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Evaluation of Prostate Cancer with ¹¹C- and ¹⁸F-Choline PET/CT: Diagnosis and Initial Staging

Cited by 31 publications

References 45 publications

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

Positron emission tomography/computed tomography-guided percutaneous trans-pararectal space prostate biopsy for the diagnosis of prostate cancer: A retrospective study

Positron emission tomography in prostate cancer: An update on state of the art

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Evaluation of Prostate Cancer with 11C- and 18F-Choline PET/CT: Diagnosis and Initial Staging

Cited by 31 publications

References 45 publications

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

Prostate-Specific Membrane Antigen Ligands for Imaging and Therapy

Positron emission tomography/computed tomography-guided percutaneous trans-pararectal space prostate biopsy for the diagnosis of prostate cancer: A retrospective study

Positron emission tomography in prostate cancer: An update on state of the art

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Evaluation of Prostate Cancer with ¹¹C- and ¹⁸F-Choline PET/CT: Diagnosis and Initial Staging