2018•Korean Journal of RadiologyOpen access

Prostate-Specific Membrane Antigen PET Imaging in Prostate Cancer: Opportunities and Challenges

So Won Oh, Gi Jeong Cheon

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Abstract

The aim of this systematic review was to describe the characteristics of prostate-specific membrane antigen (PSMA)-targeting PET and their clinical applications in prostate cancer patients. There have been major strides in the design, synthesis of PSMA-targeting PET tracers over the past several years. PSMA-targeting PET tracers can be categorized, according to positron emitters and targeting strategies for the PSMA. The majority of PSMA PET studies has been focused on patients with biochemical recurrence, but additional values of PSMA PET have also been investigated for use in primary staging, treatment planning, response evaluation, and PSMA radioligand therapy. PSMA PET is expected to bring improvements in the management of patients, but the impact of improved diagnosis by PSMA on overall survival remains unanswered. Many challenges still await PSMA PET to expedite the use in the clinical practice. At this early stage, prospective multicenter trials are needed to validate the effectiveness and usefulness of PSMA PET.

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What this paper is about

The aim of this systematic review was to describe the characteristics of prostate-specific membrane antigen (PSMA)-targeting PET and their clinical applications in prostate cancer patients. There have been major strides in the design, synthesis of PSMA-targeting PET tracers over the past several years. PSMA-targeting PET tracers can be categorized, according to positron emitters and targeting strategies for the PSMA. The majority of PSMA PET studies has been focused on patients with biochemical recurrence, but additional values of PSMA PET have also been investigated for use in primary staging, treatment planning, response evaluation, and PSMA radioligand therapy. PSMA PET is expected to bring improvements in the management of patients, but the impact of improved diagnosis by PSMA on overall survival remains unanswered. Many challenges still await PSMA PET to expedite the use in the clinical practice. At this early stage, prospective multicenter trials are needed to validate the effectiveness and usefulness of PSMA PET.

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Available abstract

The aim of this systematic review was to describe the characteristics of prostate-specific membrane antigen (PSMA)-targeting PET and their clinical applications in prostate cancer patients. There have been major strides in the design, synthesis of PSMA-targeting PET tracers over the past several years. PSMA-targeting PET tracers can be categorized, according to positron emitters and targeting strategies for the PSMA. The majority of PSMA PET studies has been focused on patients with biochemical recurrence, but additional values of PSMA PET have also been investigated for use in primary staging, treatment planning, response evaluation, and PSMA radioligand therapy. PSMA PET is expected to bring improvements in the management of patients, but the impact of improved diagnosis by PSMA on overall survival remains unanswered. Many challenges still await PSMA PET to expedite the use in the clinical practice. At this early stage, prospective multicenter trials are needed to validate the effectiveness and usefulness of PSMA PET.

Key concepts: Medicine, Prostate cancer, Glutamate carboxypeptidase II, Prostate, Prostate-specific antigen, Pathology, Cancer, Internal medicine

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