Prostate-specific Membrane Antigen-positron Emission Tomography (PSMA-PET) of Prostate Cancer: Current and Emerging Applications

Overview

Journal Abdom Radiol (NY)

Publisher Springer

Specialties Gastroenterology
Radiology

Date 2024 Feb 22

PMID 38386156

Authors

Shamus Moran

Heather H Cheng

Emily Weg

Eric H Kim

Delphine L Chen

Amir Iravani

Joseph E Ippolito

Affiliations

Soon will be listed here.

Abstract

Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is transforming the management of patients with prostate cancer. In appropriately selected patients, PSMA-PET offers superior sensitivity and specificity compared to conventional imaging (e.g., computed tomography and bone scintigraphy) as well as choline and fluciclovine PET, with the added benefit of consolidating bone and soft tissue evaluation into a single study. Despite being a newly available imaging tool, PSMA-PET has established indications, interpretation guidelines, and reporting criteria, which will be reviewed. The prostate cancer care team, from imaging specialists to those delivering treatment, should have knowledge of physiologic PSMA radiotracer uptake, patterns of disease spread, and the strengths and limitations of PSMA-PET. In this review, current and emerging applications of PSMA-PET, including appropriateness use criteria as well as image interpretation and pitfalls, will be provided with an emphasis on clinical implications.

References

Mason B, Eastham J, Davis B, Mynderse L, Pugh T, Lee R . Current Status of MRI and PET in the NCCN Guidelines for Prostate Cancer. J Natl Compr Canc Netw. 2019; 17(5):506-513. DOI: 10.6004/jnccn.2019.7306. View

Fraum T, Ludwig D, Kim E, Schroeder P, Hope T, Ippolito J . Prostate cancer PET tracers: essentials for the urologist. Can J Urol. 2018; 25(4):9371-9383. View

Ackerstaff E, Glunde K, Bhujwalla Z . Choline phospholipid metabolism: a target in cancer cells?. J Cell Biochem. 2003; 90(3):525-33. DOI: 10.1002/jcb.10659. View

Gusman M, Aminsharifi J, Peacock J, Anderson S, Clemenshaw M, Banks K . Review of F-Fluciclovine PET for Detection of Recurrent Prostate Cancer. Radiographics. 2019; 39(3):822-841. DOI: 10.1148/rg.2019180139. View

Piron S, Verhoeven J, Vanhove C, de Vos F . Recent advancements in F-labeled PSMA targeting PET radiopharmaceuticals. Nucl Med Biol. 2022; 106-107:29-51. DOI: 10.1016/j.nucmedbio.2021.12.005. View

Horoszewicz J, Kawinski E, Murphy G . Monoclonal antibodies to a new antigenic marker in epithelial prostatic cells and serum of prostatic cancer patients. Anticancer Res. 1987; 7(5B):927-35. View

Kinoshita Y, Kuratsukuri K, Landas S, Imaida K, Rovito Jr P, Wang C . Expression of prostate-specific membrane antigen in normal and malignant human tissues. World J Surg. 2006; 30(4):628-36. DOI: 10.1007/s00268-005-0544-5. View

Troyer J, Beckett M, Wright Jr G . Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids. Int J Cancer. 1995; 62(5):552-8. DOI: 10.1002/ijc.2910620511. View

Chang S, OKeefe D, Bacich D, Reuter V, Heston W, Gaudin P . Prostate-specific membrane antigen is produced in tumor-associated neovasculature. Clin Cancer Res. 1999; 5(10):2674-81. View

10.

Bostwick D, Pacelli A, Blute M, Roche P, Murphy G . Prostate specific membrane antigen expression in prostatic intraepithelial neoplasia and adenocarcinoma: a study of 184 cases. Cancer. 1998; 82(11):2256-61. DOI: 10.1002/(sici)1097-0142(19980601)82:11<2256::aid-cncr22>3.0.co;2-s. View

11.

Wright Jr G, Grob B, Haley C, Grossman K, Newhall K, Petrylak D . Upregulation of prostate-specific membrane antigen after androgen-deprivation therapy. Urology. 1996; 48(2):326-34. DOI: 10.1016/s0090-4295(96)00184-7. View

12.

Perner S, Hofer M, Kim R, Shah R, Li H, Moller P . Prostate-specific membrane antigen expression as a predictor of prostate cancer progression. Hum Pathol. 2007; 38(5):696-701. DOI: 10.1016/j.humpath.2006.11.012. View

13.

Ross J, Sheehan C, Fisher H, Kaufman Jr R, Kaur P, Gray K . Correlation of primary tumor prostate-specific membrane antigen expression with disease recurrence in prostate cancer. Clin Cancer Res. 2003; 9(17):6357-62. View

14.

Wester H, Schottelius M . PSMA-Targeted Radiopharmaceuticals for Imaging and Therapy. Semin Nucl Med. 2019; 49(4):302-312. DOI: 10.1053/j.semnuclmed.2019.02.008. View

15.

Schwenck J, Rempp H, Reischl G, Kruck S, Stenzl A, Nikolaou K . Comparison of Ga-labelled PSMA-11 and C-choline in the detection of prostate cancer metastases by PET/CT. Eur J Nucl Med Mol Imaging. 2016; 44(1):92-101. DOI: 10.1007/s00259-016-3490-6. View

16.

Calais J, Ceci F, Eiber M, Hope T, Hofman M, Rischpler C . F-fluciclovine PET-CT and Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial. Lancet Oncol. 2019; 20(9):1286-1294. PMC: 7469487. DOI: 10.1016/S1470-2045(19)30415-2. View

17.

de Feria Cardet R, Hofman M, Segard T, Yim J, Williams S, Francis R . Is Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Imaging Cost-effective in Prostate Cancer: An Analysis Informed by the proPSMA Trial. Eur Urol. 2020; 79(3):413-418. DOI: 10.1016/j.eururo.2020.11.043. View

18.

Sanchez-Crespo A . Comparison of Gallium-68 and Fluorine-18 imaging characteristics in positron emission tomography. Appl Radiat Isot. 2012; 76:55-62. DOI: 10.1016/j.apradiso.2012.06.034. View

19.

Dietlein M, Kobe C, Kuhnert G, Stockter S, Fischer T, Schomacker K . Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer. Mol Imaging Biol. 2015; 17(4):575-84. PMC: 4493776. DOI: 10.1007/s11307-015-0866-0. View

20.

Dietlein F, Kobe C, Neubauer S, Schmidt M, Stockter S, Fischer T . PSA-Stratified Performance of F- and Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer. J Nucl Med. 2016; 58(6):947-952. DOI: 10.2967/jnumed.116.185538. View