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Review
. 2018 Feb 11;8(1):16.
doi: 10.3390/diagnostics8010016.

Review of Gallium-68 PSMA PET/CT Imaging in the Management of Prostate Cancer

Nat P Lenzo  1   2 , Danielle Meyrick  3 , J Harvey Turner  4
Affiliations
Review

Review of Gallium-68 PSMA PET/CT Imaging in the Management of Prostate Cancer

Nat P Lenzo et al. Diagnostics (Basel). .

Abstract

Over 90% of prostate cancers over-express prostate specific membrane antigen (PSMA) and these tumor cells may be accurately targeted for diagnosis by 68Ga-PSMA-positron emission tomography/computed tomography (68Ga-PSMA-PET/CT) imaging. This novel molecular imaging modality appears clinically to have superseded CT, and appears superior to MR imaging, for the detection of metastatic disease. 68Ga-PSMA PET/CT has the ability to reliably stage prostate cancer at presentation and can help inform an optimal treatment approach. Novel diagnostic applications of 68Ga-PSMA PET/CT include guiding biopsy to improve sampling accuracy, and guiding surgery and radiotherapy. In addition to facilitating the management of metastatic castrate resistant prostate cancer (mCRPC), 68Ga-PSMA can select patients who may benefit from targeted systemic radionuclide therapy. 68Ga-PSMA is the diagnostic positron-emitting theranostic pair with the beta emitter Lutetium-177 PSMA (177Lu-PSMA) and alpha-emitter Actinium-225 PSMA (225Ac-PSMA) which can both be used to treat PSMA-avid metastases of prostate cancer in the molecular tumor-targeted approach of theranostic nuclear oncology.

Keywords: 68Ga-PSMA PET/CT; molecular imaging; nuclear oncology; prostate cancer; theranostics.

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Conflict of interest statement

Theranostics Australia is the Australian distributor of the ANMI PSMA-11 cold kit.

Figures

Figure 1
Figure 1
Rising PSA post-prostatectomy. PSA 0.9 ng/mL. CT unremarkable. 68Ga-PSMA-avid right pelvic lymph node.
Figure 2
Figure 2
Staging 68Ga-PSMA PET/CT. Gleason 4 + 5. PSA 19 ng/mL. Intense 68Ga-PSMA avid primary disease in prostate with 68Ga-PSMA avid superficial left inguinal node metastasis.
Figure 3
Figure 3
Primary prostate cancer. PIRADS 4/5 left lobe of prostate on multiparametric MRI. Fused to 68Ga-PSMA PET/CT images for MRI in-bore guided targeted biopsy.
Figure 4
Figure 4
Targeted radiotherapy to recurrent 68Ga-PSMA avid right pre-sacral lymph node. June 2015.
Figure 5
Figure 5
Monitoring response of targeted radiotherapy by 68Ga-PSMA PET/CT August 2016. (Previous 68Ga-PSMA avid right pre-sacral lymph node treated June 2015—see Figure 4).
Figure 6
Figure 6
Before (top) and after (bottom) 3 cycles of 177Lu-PSMA therapy for progressive metastatic castrate resistant prostate cancer. [X axis—time in months/; Y axis—PSA (μg/L)].
See this image and copyright information in PMC

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