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Clinical practice in prostate PET imaging

Positron emission tomography (PET) imaging in prostate cancer has advanced significantly in the past decade with prostate cancer targeted radiopharmaceuticals now playing a growing role in diagnosis, staging, and treatment. This narrative review focuses on the most commonly used PET radiopharmaceuti...

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Autores principales: Huls, Sean J., Burkett, Brian, Ehman, Eric, Lowe, Val J., Subramaniam, Rathan M., Kendi, A. Tuba
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666681/
https://www.ncbi.nlm.nih.gov/pubmed/38028142
http://dx.doi.org/10.1177/17588359231213618
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author Huls, Sean J.
Burkett, Brian
Ehman, Eric
Lowe, Val J.
Subramaniam, Rathan M.
Kendi, A. Tuba
author_facet Huls, Sean J.
Burkett, Brian
Ehman, Eric
Lowe, Val J.
Subramaniam, Rathan M.
Kendi, A. Tuba
author_sort Huls, Sean J.
collection PubMed
description Positron emission tomography (PET) imaging in prostate cancer has advanced significantly in the past decade with prostate cancer targeted radiopharmaceuticals now playing a growing role in diagnosis, staging, and treatment. This narrative review focuses on the most commonly used PET radiopharmaceuticals in the USA: prostate-specific membrane antigen (PSMA), fluciclovine, and choline. 18F-fluorodeoxyglucose (FDG) is used in many other malignancies, but rarely in prostate cancer. Previous literature is discussed regarding each radiopharmaceutical’s utility in the settings of screening/diagnosis, initial staging, biochemical recurrence, advanced disease, and evaluation prior to targeted radiopharmaceutical therapy and radiation therapy. PET imaging has demonstrated utility over traditional imaging in various scenarios; however, there are few head-to-head studies comparing PET radiopharmaceuticals. PSMA radiopharmaceuticals are the newest tracers developed and have unique properties and uses, especially at low prostate-specific antigen (PSA) levels. However, each PET radiopharmaceutical has different properties which can affect image interpretation. Choline and fluciclovine have minimal urinary activity, whereas PSMA agents can have high urinary activity which may affect locoregional disease evaluation. Of the three radiopharmaceuticals, only PSMA is approved for both diagnostic and therapeutic indications with (177)Lu-PSMA. A variety of diagnostic PET radiotracers for prostate cancer allows for increased flexibility, especially in the setting of supply chain and medication shortages. For the time being, keeping a diverse group of PET radiopharmaceuticals for prostate cancer is justifiable.
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spelling pubmed-106666812023-11-22 Clinical practice in prostate PET imaging Huls, Sean J. Burkett, Brian Ehman, Eric Lowe, Val J. Subramaniam, Rathan M. Kendi, A. Tuba Ther Adv Med Oncol Review Positron emission tomography (PET) imaging in prostate cancer has advanced significantly in the past decade with prostate cancer targeted radiopharmaceuticals now playing a growing role in diagnosis, staging, and treatment. This narrative review focuses on the most commonly used PET radiopharmaceuticals in the USA: prostate-specific membrane antigen (PSMA), fluciclovine, and choline. 18F-fluorodeoxyglucose (FDG) is used in many other malignancies, but rarely in prostate cancer. Previous literature is discussed regarding each radiopharmaceutical’s utility in the settings of screening/diagnosis, initial staging, biochemical recurrence, advanced disease, and evaluation prior to targeted radiopharmaceutical therapy and radiation therapy. PET imaging has demonstrated utility over traditional imaging in various scenarios; however, there are few head-to-head studies comparing PET radiopharmaceuticals. PSMA radiopharmaceuticals are the newest tracers developed and have unique properties and uses, especially at low prostate-specific antigen (PSA) levels. However, each PET radiopharmaceutical has different properties which can affect image interpretation. Choline and fluciclovine have minimal urinary activity, whereas PSMA agents can have high urinary activity which may affect locoregional disease evaluation. Of the three radiopharmaceuticals, only PSMA is approved for both diagnostic and therapeutic indications with (177)Lu-PSMA. A variety of diagnostic PET radiotracers for prostate cancer allows for increased flexibility, especially in the setting of supply chain and medication shortages. For the time being, keeping a diverse group of PET radiopharmaceuticals for prostate cancer is justifiable. SAGE Publications 2023-11-22 /pmc/articles/PMC10666681/ /pubmed/38028142 http://dx.doi.org/10.1177/17588359231213618 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Huls, Sean J.
Burkett, Brian
Ehman, Eric
Lowe, Val J.
Subramaniam, Rathan M.
Kendi, A. Tuba
Clinical practice in prostate PET imaging
title Clinical practice in prostate PET imaging
title_full Clinical practice in prostate PET imaging
title_fullStr Clinical practice in prostate PET imaging
title_full_unstemmed Clinical practice in prostate PET imaging
title_short Clinical practice in prostate PET imaging
title_sort clinical practice in prostate pet imaging
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666681/
https://www.ncbi.nlm.nih.gov/pubmed/38028142
http://dx.doi.org/10.1177/17588359231213618
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