Role of FDG PET/CT in Management of Patients with Prostate Cancer.

Autor: Sutherland DEK; Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Azad AA; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Murphy DG; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Eapen RS; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Kostos L; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Hofman MS; Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: michael.hofman@petermac.org.
Jazyk: angličtina
Zdroj: Seminars in nuclear medicine [Semin Nucl Med] 2024 Jan; Vol. 54 (1), pp. 4-13. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1053/j.semnuclmed.2023.06.005
Abstrakt: Prostate cancer is the second most common cancer in men worldwide. [ 18 F]FDG PET/CT imaging, a well-known and effective technique for detecting malignancies, has not been considered a useful tool for prostate cancer imaging by many because of its perceived low [ 18 F]FDG uptake. Incidentally detected focal [ 18 F]FDG uptake in the prostate is not uncommon, and typically benign. Imaging features that would increase concern for an underlying prostatic carcinoma, include focal uptake in the periphery near the gland margin without calcifications. [ 18 F]FDG PET/CT imaging provides little value in the initial staging of prostate cancer, particularly in the era of prostate specific membrane antigen (PSMA) radiotracer. In cases of biochemical recurrence, the value of [ 18 F]FDG PET/CT increases notably when Grade group 4 or 5 and elevated PSA levels are present. Active research is underway for theranostic approaches to prostate cancer, including [ 177 Lu]Lu-PSMA therapy. Dual tracer staging using FDG and PSMA imaging significantly enhances the accuracy of disease site assessment. Specifically, the addition of [ 18 F]FDG PET/CT imaging allows for the evaluation of discordant disease (PSMA negative/FDG positive). The maximal benefit from [ 177 Lu]Lu-PSMA therapy relies on significant PSMA accumulation across all disease sites, and the identification of discordant disease suggests that these patients may derive less benefit from the treatment. The genuine value of [ 18 F]FDG PET/CT imaging lies in advanced prostate cancer, PSMA-negative disease, as a prognostic biomarker, and the realm of new targeted theranostic agents.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Michael Hofman reports financial support was provided by Novartis (including AAA and Endocyte). Michael Hofman reports financial support was provided by AstraZeneca. Michael Hofman reports financial support was provided by Bayer Corporation. Michael Hofman reports financial support was provided by Isotopia. Michael Hofman reports financial support was provided by MIM Software Inc. Michael Hofman reports a relationship with Astellas Pharma Inc that includes: consulting or advisory. Consulting fees for lectures or advisory boards from Astellas and AstraZeneca in the last two years, and Janssen, Merck/MSD and Mundipharma in the last five years. All these potential competing interests are unrelated to this work.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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