Mei, Riccardo

Farolfi, Andrea

Morigi, Joshua James

Fanti, Stefano

2022-05-01

PURPOSE OF REVIEW: Thanks to the development of novel PSMA-based peptides, molecular imaging, such as PET/CT paired with theranostic-based approaches have recently been proposed for treatment of prostate cancer. Patient selection, however, remains challenging because of the absence of strong prospective data to interpret and translate imaging scans into effective and well tolerated treatment regimens. RECENT FINDINGS: In this review, we discuss the latest findings in PSMA imaging in prostate cancer patients. Particularly, we go into detail into the impact of PSMA imaging on the treatment management in primary staging, biochemical recurrence and in advanced prostate cancer. SUMMARY: For primary prostate cancer staging, PSMA PET/CT seems crucial for primary therapy assessment, being able in some cases to detect lesions outside the surgical template, thus permitting a change in management. Moreover, N+ condition at PSMA has been correlated with a worse biochemical recurrence-free and therapy-free survival. The early detection of PSMA-positive findings in recurrent prostate cancer is associated with a better time to relapse survival. Similarly, for advanced prostate cancer patients, accurate restaging with PSMA imaging is gaining importance for early prediction of response to systemic therapies and to assure the best outcome possible. With regards to theranostics, appropriate selection of patients eligible for 177Lu-PSMA requires PSMA imaging, whereas the role of added FDG-PET for discriminating those with PSMA/FDG discordance needs to be further evaluated.

Nuclear Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna.

DIMES, University of Bologna, Bologna, Italy.

PET/CT Unit, Department of Medical Imaging, Royal Darwin Hospital, Darwin, Australia.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Curr Opin Urol. 2022 May 1;32(3):269-276. doi: 10.1097/MOU.0000000000000982.

https://pubmed.ncbi.nlm.nih.gov/35552308/?otool=iaurydwlib

https://hdl.handle.net/10137/12175

32

Fluorodeoxyglucose F18

Humans

Male

Neoplasm Recurrence, Local/diagnostic imaging/pathology

*Positron Emission Tomography Computed Tomography/methods

Prospective Studies

Prostate/pathology

*Prostatic Neoplasms/diagnostic imaging/pathology/therapy

The role of prostate-specific membrane antigen PET/computed tomography in the management of prostate cancer patients: could we ask for more?

Journal Article

Review

Publication