Molecular Imaging of Prostate Cancer

Abstract

Prostate cancer is the most common noncutaneous malignancy among men in the Western world. The natural history and clinical course of prostate cancer are markedly diverse, ranging from small indolent intraprostatic lesions to highly aggressive disseminated disease. An understanding of this biologic heterogeneity is considered a necessary requisite in the quest for the adoption of precise and personalized management strategies. Molecular imaging offers the potential for noninvasive assessment of the biologic interactions underpinning prostate carcinogenesis. Currently, numerous molecular imaging probes are in clinical use or undergoing preclinical or clinical evaluation. These probes can be divided into those that image increased cell metabolism, those that target prostate cancer-specific membrane proteins and receptor molecules, and those that bind to the bone matrix adjacent to metastases to bone. The increased metabolism and vascular changes in prostate cancer cells can be evaluated with radiolabeled analogs of choline, acetate, glucose, amino acids, and nucleotides. The androgen receptor, prostate-specific membrane antigen, and gastrin-releasing peptide receptor (ie, bombesin) are overexpressed in prostate cancer and can be targeted by specific radiolabeled imaging probes. Because metastatic prostate cancer cells induce osteoblastic signaling pathways of adjacent bone tissue, bone-seeking radiotracers are sensitive tools for the detection of metastases to bone. Knowledge about the underlying biologic processes responsible for the phenotypes associated with the different stages of prostate cancer allows an appropriate choice of methods and helps avoid pitfalls. F-16b-fluoro5a-dihydrotestosterone, PSA = prostate-specific antigen, PSMA = prostate-specific membrane antigen

Value of 68Ga-PSMA HBED-CC PET for the Assessment of Lymph Node Metastases in Prostate Cancer Patients with Biochemical Recurrence: Comparison with Histopathology After Salvage Lymphadenectomy

“…These limitations might be overcome by molecular imaging techniques (9). For example, 11 C-choline PET/CT can detect LNM in recurrent PC sensitively, however, it is not able to detect smallvolume lesions (10).…”

Diagnosis of prostate cancer using anti-PSMA aptamer A10-3.2-oriented lipid nanobubbles

“…After intravenous injection, they can specifically bind to molecules expressed on human tissues and cells to achieve molecular imaging of lesioned tissues in vivo. [29][30][31] PSMA has high levels of specific expression in both androgen-dependent prostate cancer and androgen-independent prostate cancer, and has become a commonly used target in the molecular imaging of prostate cancer. Currently, a variety of ligands against PSMA have been extensively applied in fluorescence imaging, MRI, and molecular nuclear medicine.…”

PET Tracers Beyond FDG in Prostate Cancer

“…46–49 Many amino acid transporter systems are over-expressed in prostate cancer, particularly the system ASC transporter ASCT2 and the system L transporter LAT1, which have been associated with tumor aggressiveness and poor survival. 50–59 In addition glutamine utilization as an energy source within cancer cells and the role of leucine and glutamine in mammalian target of rapamycin (mTOR) cancer signalling have drawn attention for potential therapeutic targeting strategies.…”