Prostate-specific Membrane Antigen PET: Therapy Response Assessment in Metastatic Prostate Cancer
| Autor: | Felipe de Galiza Barbosa, José Flávio Gomes Marin, Daniela A. Ferraro, Marcelo Queiroz, Elaine C. Zaniboni, Priscilla R. Dreyer, Larissa B. Costa, Rafael F. Nunes, Carlos Alberto Buchpiguel, Diogo Assed Bastos |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty medicine.medical_treatment 030218 nuclear medicine & medical imaging Androgen deprivation therapy 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine Positron Emission Tomography Computed Tomography medicine Glutamate carboxypeptidase II Biomarkers Tumor Humans Radiology Nuclear Medicine and imaging Neoplasm Metastasis Response Evaluation Criteria in Solid Tumors medicine.diagnostic_test business.industry Patient Selection Prostatic Neoplasms Immunotherapy Prostate-Specific Antigen medicine.disease Positron emission tomography 030220 oncology & carcinogenesis Positron-Emission Tomography Radionuclide therapy Biomarker (medicine) Radiopharmaceuticals business |
| Zdroj: | Radiographics : a review publication of the Radiological Society of North America, Inc. 40(5) |
| ISSN: | 1527-1323 |
| Popis: | Therapy response assessment is a critical step in cancer management, leading clinicians to optimize the use of therapeutic options during the course of the disease. Imaging is a pivotal biomarker for therapy response evaluation in oncology and has gained wider use through the development of reproducible data-based guidelines, of which the Response Evaluation Criteria in Solid Tumors is the most successful example. Disease-specific criteria have also been proposed, and the Prostate Cancer Working Group 3 criteria are the mainstay for prostate cancer (PC). However, conventional imaging evaluation in metastatic PC has several limitations, including (a) the inability to detect small-volume disease, (b) the high prevalence of bone (nonmeasurable) lesions at imaging, and (c) the established role of serum prostate-specific antigen (PSA) levels as the biomarker of choice for response assessment and disease progression. In addition, there are an increasing number of newer treatment options with various effects on imaging features. Prostate-specific membrane antigen (PSMA) PET has improved patient selection for newer treatments, such as metastasis-directed therapy (MDT) or radionuclide therapy. The role of PSMA PET in response assessment for many metastatic PC therapeutic options (MDT, androgen deprivation therapy, chemotherapy, radionuclide therapy, and immunotherapy) is an evolving issue, with emerging data showing good correlation with PSA levels and clinical outcome. However, there are specific implications of each therapy (especially androgen deprivation therapy and immunotherapy) on PSMA expression by PC cells, leading to potential pitfalls and inaccuracies that must be known by radiologists. Despite some limitations, PSMA PET is addressing gaps left by conventional imaging methods (eg, CT and bone scanning) and nonimaging biomarkers (PSA levels) in metastatic PC therapy response assessment, a role that can be improved with advances like refinement of interpretation criteria and whole-body tumor burden quantification.© RSNA, 2020See discussion on this article by Barwick and Castellucci. |
| Databáze: | OpenAIRE |
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