Imaging of prostate cancer with positron emission tomography

Abstract

Prostate cancer is most commonly imaged through a combination of magnetic resonance imaging, x-ray computed tomography, and ^99mTc-methylene diphosphonate bone scan. These conventional imaging modalities, however, suffer from limited sensitivity and specificity for the detection of disease. This can lead to disease understaging and the improper selection of treatment. To address this problem, a variety of novel radiotracers for positron emission tomography (PET) imaging have been developed. This includes agents that accumulate on the basis of alterations in cellular metabolism (eg, ¹¹C-choline and ¹⁸F-FACBC) as well as those that bind to specific proteins (eg, ⁶⁸Ga-PSMA-11, ¹⁸F-DCFPyL, ⁶⁸Ga-RM2, and ¹⁸F-DHT). In this review, we examine the performance characteristics of these new PET radiotracers for imaging prostate cancer and discuss ways in which PET imaging can offer more precise clinical information to patients and providers.