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Review
. 2024 Jun;27(2):202-211.
doi: 10.1038/s41391-023-00711-0. Epub 2023 Sep 7.

Application of next-generation imaging in biochemically recurrent prostate cancer

Judd W Moul #  1 , Neal D Shore #  2 , Kenneth J Pienta  3 , Johannes Czernin  4 , Martin T King  5 , Stephen J Freedland  6   7
Affiliations
Review

Application of next-generation imaging in biochemically recurrent prostate cancer

Judd W Moul et al. Prostate Cancer Prostatic Dis. 2024 Jun.

Erratum in

Abstract

Background: Biochemical recurrence (BCR) following primary interventional treatment occurs in approximately one-third of patients with prostate cancer (PCa). Next-generation imaging (NGI) can identify local and metastatic recurrence with greater sensitivity than conventional imaging, potentially allowing for more effective interventions. This narrative review examines the current clinical evidence on the utility of NGI for patients with BCR.

Methods: A search of PubMed was conducted to identify relevant publications on NGI applied to BCR. Given other relevant recent reviews on the topic, this review focused on papers published between January 2018 to May 2023.

Results: NGI technologies, including positron emission tomography (PET) radiotracers and multiparametric magnetic resonance imaging, have demonstrated increased sensitivity and selectivity for diagnosing BCR at prostate-specific antigen (PSA) concentrations <2.0 ng/ml. Detection rates range between 46% and 50%, with decreasing PSA levels for choline (1-3 ng/ml), fluciclovine (0.5-1 ng/ml), and prostate-specific membrane antigen (0.2-0.49 ng/ml) PET radiotracers. Expert working groups and European and US medical societies recommend NGI for patients with BCR.

Conclusions: Available data support the improved detection performance and selectivity of NGI modalities versus conventional imaging techniques; however, limited clinical evidence exists demonstrating the application of NGI to treatment decision-making and its impact on patient outcomes. The emergence of NGI and displacement of conventional imaging may require a reexamination of the current definitions of BCR, altering our understanding of early recurrence. Redefining the BCR disease state by formalizing the role of NGI in patient management decisions will facilitate greater alignment across research efforts and better reflect the published literature.

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Conflict of interest statement

J.W.M.: Stock or Other Ownership: AstraZeneca, Bavarian Nordic, Eli Lilly and Company, Johnson & Johnson, Novartis, Pfizer, Procter & Gamble, Theralogix LLC, Walgreens; Honoraria: AbbVie, Astellas Pharma, Bayer, Ferring Pharmaceuticals, Dendreon Pharmaceuticals, GenomeDx Biosciences, Genomic Health, Janssen, Pfizer, Sanofi; Consulting or Advisory Role: AbbVie, Bayer, Blue Earth Diagnostics Ltd, Theralogix LLC, Tolmar Inc.; Speakers’ Bureau: Bayer, Ferring Pharmaceuticals, Dendreon Pharmaceuticals, GenomeDx Biosciences, Genomic Health, Janssen, Sanofi; Research Funding: Astellas Pharma (Inst), Pfizer (Inst). N.D.S.: Grant Support and Consulting Fees: AbbVie, Amgen, Astellas Pharma, Bayer, Dendreon Pharmaceuticals, Ferring Pharmaceuticals, Janssen Oncology, Pfizer, Sanofi–Genzyme, and Tolmar Inc. K.J.P.: Founder and Equity Holder: Keystone Biopharma, Inc.; Consultant: Cue Biopharma, Inc.; Research Funding: Progenics Pharmaceuticals, Inc. J.C.: Founder, Board Member, and Equity Holder: Sofie Biosciences, Trethera Therapeutics; Advisory Board Member: Actinium Pharmaceuticals Inc, Aktis Oncology, Amgen, Jubilant Radiopharma. M.T.K.: Grant Support and Consulting Fees: Bayer, Palette Life Sciences. S.J.F.: Consultant: Astellas Pharma, AstraZeneca, Bayer, Dendreon Pharmaceuticals, Janssen, Merck, Myovant Sciences, Pfizer, Sanofi.

Figures

Fig. 1
Fig. 1
Utility of next-generation imaging for the assessment and clinical management of biochemical recurrence in prostate cancer [14, 28, 31, 32, 34, 35, 43, 46, 53, 67, 70, 72, 73, 97].
See this image and copyright information in PMC

References

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