Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET/CT vs PET/MRI

2021 ◽  
Author(s):  
Feng-Yuan Liu ◽  
Ting-Wen Sheng ◽  
Jing-Ren Tseng ◽  
Kai-Jie Yu ◽  
Ke-Hong Tsui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Tumor Staging ◽  
Distant Metastases ◽  
Local Tumor ◽  
Pet Ct ◽  
Primary Tumor Detection

Objectives: To investigate whether PET/CT or PET/MRI is more appropriate for imaging prostate cancer, in terms of for primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. Methods: A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET/CT vs PET/MRI in prostate cancer patients were emphasized. Results: We reviewed 57 original research articles during the period 2016—2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET/MRI is better than PET/CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET/MRI is likely superior as compared with PET/CT in detecting local recurrence, and have slightly higher detection rates than PET/CT in lymph node recurrence. PET/CT and PET/MRI seem to have equivalent performance in detecting distant bony or visceral metastases. Conclusion: In conclusion, PET/MRI is suitable for local and regional disease, either primary staging or restaging whereas PET/CT is valuable for managing distant bony or visceral metastasis. Advances in knowledge: We reviewed the emerging applications of PET/MRI and PET/CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET/MRI or PET/CT in the management of prostate cancer.

Study of PSMA-targeted 18F-DCFPyL PET/CT in the evaluation of men with an elevated PSA following radical prostatectomy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 299-299
Author(s):  
Michael A. Gorin ◽  
Steven P. Rowe ◽  
Margarita Mana-ay ◽  
Zsolt Szabo ◽  
Edward M. Schaeffer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Local Recurrence ◽  
Bone Scan ◽  
Conventional Imaging ◽  
Imaging Test ◽  
Imaging Results ◽  
Pet Ct ◽  
Bony Lesions

299 Background: Positron emission tomography/x−ray computed tomography (PET/CT) utilizing radiotracers targeting prostate membrane specific antigen (PSMA) offer the promise of improved sensitivity for visualizing low volume sites of prostate cancer. In this study we evaluated the sensitivity of PET/CT using 18F-DCFPyL, a novel small molecule ligand of PSMA, for imaging sites of disease in men with an elevated PSA following radical prostatectomy. Methods: Patients with an elevated PSA following radical prostatectomy (defined as ≥ 0.2 ng/mL) were imaged with CT or magnetic resonance imaging (MRI) of the abdomen and pelvis, 99mTc-methylene diphosphonate bone scan and 18F-DCFPyL PET/CT. Conventional imaging studies (CT, MRI and boen scan) were clinically reviewed by readers blinded to the PET/CT scan results. Similarly, PET/CT scans were blindly reviewed and then the sensitivity of this novel imaging test was compared to that of conventional imaging. Results: In total, 12 men with a median PSA of 0.34 ng/mL (range 0.2 to 11) were imaged as part of this study. 2 (16.7%) patients had persistently elevated PSA values after surgery and 10 (83.3%) had values which were initially undetectable but then rose to ≥ 0.2 ng/mL. On conventional imaging, only 4 (25.0%) patients had at least 1 detectable site of disease. This included 1 patient with a local recurrence detected on MRI and 3 patients with bony lesions detected on bone scan. In contrast, 9 (75.0%) patients had areas of detectable disease on PET/CT. This included 3 (25.0%) patients with a local recurrence, 3 (25.0%) with lymph node metastases, 2 (16.7%) with bony lesions and 1 (8.3%) with both lymph node and bone findings. All lesions detected on conventional imaging had corresponding areas of radiotracer uptake on PET/CT. Conclusions: 18F-DCFPyL PET/CT appears to be more sensitive for detecting areas of prostate cancer recurrence in patients with an elevated PSA following radical prostatectomy. Future work aims to more precisely define the sensitivity of this imaging test in a larger patient cohort. Clinical trial information: NCT02523924.

scholarly journals Value of PET/CT and MR Lymphography in Treatment of Prostate Cancer Patients With Lymph Node Metastases

2012 ◽  
Vol 84 (3) ◽  
pp. 712-718 ◽  
Author(s):  
Ansje S. Fortuin ◽  
Willem M.L.L.G. Deserno ◽  
Hanneke J.M. Meijer ◽  
Gerrit J. Jager ◽  
Satoru Takahashi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Metastases ◽  
Pet Ct ◽  
Mr Lymphography ◽  
Node Metastases

scholarly journals Early injection of furosemide increases detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for 68Ga-PSMA-11 PET/CT.

2021 ◽  
pp. jnumed.120.261866
Author(s):  
Christian Uprimny ◽  
Steffen Bayerschmidt ◽  
Alexander Stephan Kroiss ◽  
Josef Fritz ◽  
Bernhard Nilica ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Detection Rate ◽  
Pet Ct ◽  
Early Injection

scholarly journals Multiparametric MRI and 18F-DCFPyL PET/CT for detection of locally recurrent prostate cancer after low dose rate brachytherapy

2020 ◽  
Author(s):  
Stephanie M. Walker ◽  
Martina Fernandez ◽  
Soumyajit Roy ◽  
Esther Mena ◽  
Jonathan Sackett ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Lymph Nodes ◽  
Dose Rate ◽  
Low Dose ◽  
Imaging Modality ◽  
Low Dose Rate ◽  
Ldr Brachytherapy ◽  
Pet Ct

Abstract Background and purpose: Both multiparametric magnetic resonance imaging (mpMRI) and prostate specific membrane antigen (PSMA)-targeting positron emission tomography (PET) imaging have shown promise in early localization of prostate cancer (PCa) recurrence after primary external beam radiotherapy. Detecting recurrence after brachytherapy for PCa using MRI is significantly hampered by susceptibility artifacts secondary to brachy seeds. Here, we compare the efficacy of 18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) PET/CT versus mpMRI for detecting sites of local recurrence after low dose rate (LDR) brachytherapy for prostate cancer.Materials and methods: A total of 155 patients with a history of recurrent PCa who underwent mpMRI at 3 Tesla and 18F-DCFPyL PET/CT were retrospectively reviewed. Patients who underwent LDR brachytherapy for PCa and had subsequent biochemical recurrence (BCR) followed by mpMRI and 18F-DCFPyL PET/CT were included in this study. mpMRI was performed on a 3T scanner with endorectal and surface coils and images were prospectively read by a single expert radiologist. The 18F-DCFPyL PET/CT scan was prospectively interpreted by two nuclear medicine physicians. Patients underwent targeted biopsy when deemed clinically necessary and specimens were interpreted by an expert GU pathologist. Positivity rates (PR) from mpMRI and 18F-DCFPyL PET/CT were compared, and pathology results were used to calculate the positive predictive value (PPV) of each imaging modality for detecting PCa recurrence.Results: 15 patients who underwent LDR brachytherapy and had subsequent biochemical failure were imaged with mpMRI and 18F-DCFPyL PET/CT. 18 non-lymph node lesions were identified on at least one imaging modality. The PR for detection of intraprostatic lesions was 60% (9/15) for both PET/CT and mpMRI, with 3 prostate lesions detected by only one modality. 18F-DCFPyL PET/CT identified pelvic and extra-pelvic lymph nodes in 8 (53%) patients, while mpMRI noted positive lymph node findings in only 2 (13%) patients. A total of 15 lesions corresponding to 9 patients were targeted for biopsy. The PPV of 18F-DCFPyL PET/CT and mpMRI for the detection of local recurrence were 84.6% and 71.4%, respectively. For the detection of intraprostatic lesions, 18F-DCFPyL PET/CT and mpMRI had a PPV of 87.5% and 71.4%, respectively. Conclusion: This case series analysis suggests that 18F-DCFPyL PET/CT may detect local and regional recurrent PCa after LDR brachytherapy at a higher rate than mpMRI and that it has the potential to detect suspicious pelvic lymph nodes at a much higher rate. Further studies are needed to validate these findings in larger cohorts.

scholarly journals Lymph Node Involvement in Treatment-Naïve Prostate Cancer Patients: Correlation of PSMA PET/CT Imaging and Roach Formula in 280 Men in Radiotherapeutic Management

2019 ◽  
Vol 61 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Stefan A. Koerber ◽  
Gerald Stach ◽  
Clemens Kratochwil ◽  
Matthias F. Haefner ◽  
Henrik Rathke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Involvement ◽  
Ct Imaging ◽  
Psma Pet ◽  
Pet Ct ◽  
Treatment Naïve ◽  
Node Involvement

Survival in surgically treated, nodal positive prostate cancer patients is predicted by histopathological characteristics of the primary tumor and its lymph node metastases

The Prostate ◽  
2009 ◽  
Vol 69 (4) ◽  
pp. 352-362 ◽  
Author(s):  
Achim Fleischmann ◽  
Sylviane Schobinger ◽  
Martin Schumacher ◽  
George N. Thalmann ◽  
Urs E. Studer
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Node Metastases

Role of 68-Ga-PSMA-PET/CT in pelvic radiotherapy field definitions for lymph node coverage in prostate cancer patients

2020 ◽  
Vol 151 ◽  
pp. 222-227 ◽  
Author(s):  
Cem Onal ◽  
Gokhan Ozyigit ◽  
Ozan Cem Guler ◽  
Pervin Hurmuz ◽  
Nese Torun ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Pelvic Radiotherapy ◽  
Psma Pet ◽  
Pet Ct ◽  
Radiotherapy Field
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