[Hybrid imaging in prostate cancer : Status quo and future applications]

Abstract

Background: Recently, the use of prostate-specific membrane antigen (PSMA) tracers like 68Ga-PSMA-11 in positron emission tomography (PET) have shown promising results and are helping to improve care for patients with prostate cancer (PC).

Purpose: In the following we review the current literature on PSMA-ligand PET, in particular with regard to the currently increasing replacement of 68Ga-PSMA ligands by 18F-labeled PSMA ligands.

Results: PSMA-ligand PET is most frequently used for biochemical recurrence. Here, 68Ga-PSMA-11 PET/CT shows superior detection rates compared to conventional imaging modalities, especially in small, morphologically unsuspicious lesions, even at low PSA values. Furthermore, 68Ga-PSMA PET imaging seems to be an encouraging alternative for staging of high-risk patients, particularly in combination with multiparametric MRI.

Conclusion: The use of PSMA-ligand PET has revolutionized PC imaging. Thus, PSMA-ligand PET is expected to play an even greater role in PC diagnostics in the future, especially as 18F-labeled PSMA ligands are now increasingly used. However, simultaneous image analysis of PET and CT as well as a differentiated image evaluation (clinical context, knowledge of common pitfalls) is mandatory.

Keywords: Biochemical recurrence; Positron emission tomography; Prostate cancer; Prostate-specific membrane antigen; Salvage therapy.