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Review
. 2021 Mar;39(3):687-699.
doi: 10.1007/s00345-020-03344-3. Epub 2020 Jul 15.

Novel PET imaging methods for prostate cancer

Esther Mena  1 , Peter C Black  2 , Soroush Rais-Bahrami  3 , Michael Gorin  4 , Mohamad Allaf  4 , Peter Choyke  5
Affiliations
Review

Novel PET imaging methods for prostate cancer

Esther Mena et al. World J Urol. 2021 Mar.

Abstract

Introduction: Prostate cancer is a common neoplasm but conventional imaging methods such as CT and bone scan are often insensitive. A new class of PET agents have emerged to diagnose and manage prostate cancer.

Methods: The relevant literature on PET imaging agents for prostate cancer was reviewed.

Results: This review shows a broad range of PET imaging agents, the most successful of which is prostate specific membrane antigen (PSMA) PET. Other agents either lack the sensitivity or specificity of PSMA PET.

Conclusion: Among the available PET agents for prostate cancer, PSMA PET has emerged as the leader. It is likely to have great impact on the diagnosis, staging and management of prostate cancer patients.

Keywords: Biochemical recurrence; Molecular imaging; Prostate cancer; Prostate-specific membrane antigen; Staging.

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Conflict of interest statement

Conflicts of interest/Competing interests

Dr. Soroush Rais-Bahrami has received research funding from Genomic Health Inc, Blue Earth Diagnostics, and Astellas. Soroush Rais-Bahrami serves as a consultant for Philips/InVivo Corp, Blue Earth Diagnostics, Genomic Health Inc, Intuitive Surgical, and Bayer Healthcare. Other authors have no disclosures.

Figures

Figure 1:
Figure 1:
61-years old man with biochemical recurrent prostate cancer, status post HIFU and salvage IMRT 5 ears ago, and recent rising PSA of 2.5ng/ml. 18F-Fluciclovine PET/CT imaging, including maximal intensity projection (A) and axial fused PET/CT images (B1, B2, 3) demonstrates focal increased uptake fusing to sub-centimeter left external iliac (B1), and left common iliac (B2, B3) lymph nodes.
Figure 2:
Figure 2:
55-years-old man with newly diagnosed high-risk prostate cancer, Gleason 9 (4+5) and PSA of 20.95ng/ml. 18F-DCFPYL PET/CT imaging, including maximal intensity projection (A), axial PET (B1) and axial fused PET/CT (B2) images demonstrate intraprostatic DCFPYL-avid focus at the right mid-base posterolateral peripheral zone of the prostate, consistent with the biopsy-proven primary malignancy. There are no suspicious DCFPYL-avid focus to suggest metastatic disease.
Figure 3:
Figure 3:
74-years-old man with biochemical recurrence prostate cancer, status post-prostatectomy 5 yers ago, with rising PSA of 2.23ng/ml at the time of the scan. 18F-DCFPYL PET/CT including maximal intensity projection (A), axial PET (B1) and axial fused PET/T (B2) images demonstrate a 0.5cm DCFPYL-avid left obturator lymph node. Physiologic uptake is seen in bilateral ureters.
Figure 4:
Figure 4:
64-years-old man with history of prostate cancer, Gleason 9 (4+5), status post EBRT and 1 year of ADT with PSA nadir of 0.4ng/ml, and recent rising PSA of 2.86ng/ml. 18F-DCFPYL PET/CT imaging, including maximal intensity projection (A), axial PET (B row) and axial fused PET/CT (C row) images demonstrate an intense DCFPYL avid focus at the midline of the seminal sevicles (B1, C1) and several subcentimeter pelvis lymph nodes including left presacral (B2, C2) and bilateral common iliac nodes (B2, C3).
Figure 5:
Figure 5:
62-year-old man with metastatic castrate resistant prostate cancer, and PSA of 134ng/ml. 18F-DCFPYL imaging, including maximal intensity projection (A), and axial and sagittal fused PET/CT images (B1, B2, B3) demonstrate liver metastases (B1) and wide-spread osseous metastatic disease (A, B2, B3).
See this image and copyright information in PMC

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