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PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Authors :
Urso, Luca
Filippi, Luca
Castello, Angelo
Marzola, Maria Cristina
Bartolomei, Mirco
Cittanti, Corrado
Florimonte, Luigia
Castellani, Massimo
Zucali, Paolo
Bruni, Alessio
Sabbatini, Roberto
Dominici, Massimo
Panareo, Stefano
Evangelista, Laura
Source :
Journal of Clinical Medicine; Nov2023, Vol. 12 Issue 22, p7130, 14p
Publication Year :
2023

Abstract

Background: prostate-specific membrane antigen (PSMA) ligand PET has been recently incorporated into international guidelines for several different indications in prostate cancer (PCa) patients. However, there are still some open questions regarding the role of PSMA ligand PET in castration-resistant prostate cancer (CRPC). The aim of this work is to assess the clinical value of PSMA ligand PET/CT in patients with CRPC. Results: PSMA ligand PET has demonstrated higher detection rates in comparison to conventional imaging and allows for a significant reduction in the number of M0 CRPC patients. However, its real impact on patients' prognosis is still an open question. Moreover, in CRPC patients, PSMA ligand PET presents some sensitivity and specificity limitations. Due to its heterogeneity, CRPC may present a mosaic of neoplastic clones, some of which could be PSMA−/FDG+, or vice versa. Likewise, unspecific bone uptake (UBU) and second primary neoplasms (SNPs) overexpressing PSMA in the neoangiogenic vessels represent potential specificity issues. Integrated multi-tracer imaging (PSMA ligand and [<superscript>18</superscript>F]FDG PET) together with a multidisciplinary discussion could allow for reaching the most accurate evaluation of each patient from a precision medicine point of view. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
12
Issue :
22
Database :
Complementary Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
173830960
Full Text :
https://doi.org/10.3390/jcm12227130