FDG PET for evaluating the change of glucose metabolism in prostate cancer after androgen ablation

Abstract

In the clinical study of prostate cancer, the effect of androgen ablation on glucose metabolism in cancer tissue has not been elucidated. The purpose of this study was to investigate the change in glucose utilization due to endocrine therapy for prostate adenocarcinoma. Ten patients with histologically proven prostate cancer were prospectively investigated with (18)F-fluorodeoxyglucose and positron emission tomography (FDG PET) prior to and after the initiation of endocrine therapy. FDG uptake was calculated to measure glucose utilization in cancer tissue. The change in FDG accumulation was compared with changes in serum prostate specific antigen (PSA) level and prostate size. FDG accumulation in the prostate decreased in all patients 1-5 months after the initiation of hormone therapy. The serum PSA level and prostate size measured on computerized tomography (CT) also decreased in these periods. A decrease in FDG accumulation was also demonstrated in metastatic sites. In this study, there appeared to be a decrease in FDG uptake in prostate cancer after endocrine therapy not only in primary prostate cancer lesions but also at metastatic sites, suggesting that the glucose utilization by tumours was suppressed by androgen ablation.

Monitoring Predominantly Cytostatic Treatment Response with 18F-FDG PET

“…A single clinical study reported the utility of 18 F-FDG PET done at baseline and 1-5 mo after antiandrogen therapy with goserelin (51). 18 F-FDG uptake decreased to 66.4% of that at baseline in all 10 patients studied, concomitantly with a reduction in the PSA level (51).…”

PET of Glucose Metabolism and Cellular Proliferation in Prostate Cancer

“…Other studies have shown that 18 F-FDG uptake in metastatic lesions declines with successful androgen deprivation therapy or chemotherapy ( Fig. 1) (27,28). Although these preliminary studies are encouraging, there is clearly a need for additional experience in this clinical scenario.…”

Recent Development and Trends in Molecular Imaging Probes for Prostate Cancer

“…[18F]-fluorodeoxyglucose (FDG) (17) is a well known molecular imaging probe for monitoring tissue glucose metabolism in clinical trial [39,40]. Because of the advantages of the known mechanism that most tumors are hypermetabolic with increased glucose metabolism (Warburg effect), this probe is more suitable for assessing the glucose metabolism for prostate cancer.…”