Subscribe to RSS
DOI: 10.1055/s-0042-108860
Nuclear Medicine Imaging of Prostate Cancer
Nuklearmedizinische Diagnostik des ProstatakarzinomsPublication History
15 November 2015
05 May 2016
Publication Date:
14 June 2016 (online)
Abstract
The new tracer Gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) yields new promising options for the PET/CT diagnosis of prostate cancer (PCa) and its metastases. To overcome limitations of hybrid imaging, known from the use of choline derivatives, seems to be possible with the use of Ga-68 PSMA for PCa. The benefits of hybrid imaging with Ga-68 PSMA for PCa compared to choline derivatives shall be discussed in this article based on an overview of the current literature.
Key Points:
• Ga-68 PSMA PET/CT can achieve higher detection rates of PCa lesions than PET/CT performed with choline derivatives
• The new tracer Ga-68 PSMA has the advantage of high specificity, independence of PSA-level and low nonspecific tracer uptake in surrounding tissue
• The new tracer Ga-68 PSMA seems very suitable for MR-PET diagnostic
Citation Format:
• Schreiter V, Reimann C, Geisel D et al. Nuclear Medicine Imaging of Prostate Cancer. Fortschr Röntgenstr 2016; 188: 1037 – 1044
Zusammenfassung
Der neue Tracer Gallium-68 prostataspezifisches Membranantigen (Ga-68 PSMA) eröffnet für die PET/CT Diagnostik des Prostatakarzinoms (PCa) und seiner Metastasen neue vielversprechende Optionen. Bekannte Limitationen der Fusionsbildgebung unter Anwendung der, vor Einführung dieses Tracers verwendeten Cholin-Derivate, scheinen überwindbar. Welche Vorteile die Fusionsbildgebung unter Verwendung von Ga-68 PSMA für die PCa-Diagnostik bringt und welchen Stellenwert sie gegenüber den Cholin-Derivaten einnimmt, soll anhand eines aktuellen Literaturüberblicks in dieser Arbeit dargelegt werden.
-
Literatur
- 1 Afshar-Oromieh A, Malcher A, Eder M et al. PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging 2013; 40: 486-495
- 2 Afshar-Oromieh A, Zechmann CM, Malcher A et al. Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging 2014; 41: 11-20
- 3 Demirkol MO, Acar Ö, Uçar B et al. Prostate-specific membrane antigen-based imaging in prostate cancer: impact on clinical decision making process. Prostate 2015; 75: 748-757
- 4 Afshar-Oromieh A, Avtzi E, Giesel FL et al. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging 2015; 42: 197-209
- 5 Eiber M, Maurer T, Souvatzoglou M et al. Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy. J Nucl Med 2015; 56: 668-674
- 6 Dietlein M, Kobe C, Kuhnert G et al. Comparison of [(18)F]DCFPyL and [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer. Mol Imaging Biol 2015; 17: 575-584
- 7 Afshar-Oromieh A, Hetzheim H, Kratochwil C et al. The theranostic PSMA-ligand PSMA-617 in the diagnosis of prostate cancer by PET/CT: biodistribution in humans, radiation dosimetry and first evaluation of tumor lesions. J Nucl Med 2015 ; 56: 1697-1705
- 8 Sterzing F, Kratochwil C, Fiedler H et al. (68)Ga-PSMA-11 PET/CT: a new technique with high potential for the radiotherapeutic management of prostate cancer patients. Eur J Nucl Med Mol Imaging 2015; 43: 34-41
- 9 Giesel FL, Fiedler H, Stefanova M et al. PSMA PET/CT with Glu-urea-Lys-(Ahx)-[(68)Ga(HBED-CC)] versus 3D CT volumetric lymph node assessment in recurrent prostate cancer. Eur J Nucl Med Mol Imaging 2015; 42: 1794-1800
- 10 Maurer T, Kübler H, Gschwend JE et al. Positronenemissionstomografie bei urologischen Tumorerkrankungen. Urologe A 2015; 54: 983-991
- 11 Ummanni R, Mundt F, Pospisil H et al. Identification of clinically relevant protein targets in prostate cancer with 2D-DIGE coupled mass spectrometry and systems biology network platform. PLoS ONE 2011; 6: e16833
- 12 Siegel R, Ma J, Zou Z et al. Cancerstatistics, 2014. CA Cancer J Clin 2014; 64: 9-29
- 13 Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359-E386
- 14 Andriole GL, Crawford ED, Grubb RL et al. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 2009; 360: 1310-1319
- 15 Beheshti M, Langsteger W, Fogelman I. Prostate cancer: role of SPECT and PET in imaging bone metastases. SeminNucl Med 2009; 39: 396-407
- 16 Kosuri S, Akhtar NH, Smith M et al. Review of salvage therapy for biochemically recurrent prostate cancer: the role of imaging and rationale for systemic salvage targeted anti-prostate-specific membrane antigen radioimmunotherapy. AdvUrol 2012; 2012: 921674
- 17 Israeli RS, Powell CT, Fair WR et al. Molecular cloning of a complementary DNA encoding a prostate-specific membrane antigen. Cancer Res 1993; 53: 227-230 ; PMID: 8417812
- 18 Silver DA, Pellicer I, Fair WR et al. Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res 1997; 3: 81-85 ; PMID: 9815541
- 19 Horoszewicz JS, Kawinski E, Murphy GP. Monoclonal antibodies to a new antigenic marker in epithelial prostatic cells and serum of prostatic cancer patients. Anticancer Res 1987; 7: 927-935 ; PMID: 2449118
- 20 Fair WR, Israeli RS, Heston WD. Prostate-specific membrane antigen. Prostate 1997; 32: 140-148 ; PMID: 9215402
- 21 O'Keefe DS, Bacich DJ, Heston WDW. Comparative analysis of prostate-specific membrane antigen (PSMA) versus a prostate-specific membrane antigen-like gene. Prostate 2004; 58: 200-210
- 22 Cunha AC, Weigle B, Kiessling A et al. Tissue-specificity of prostate specific antigens: comparative analysis of transcript levels in prostate and non-prostatic tissues. Cancer Lett 2006; 236: 229-238
- 23 Murphy GP, Elgamal AA, Su SL et al. Current evaluation of the tissue localization and diagnostic utility of prostate specific membrane antigen. Cancer 1998; 83: 2259-2269 ; PMID: 9840525
- 24 Israeli RS, Powell CT, Corr JG et al. Expression of the prostate-specific membrane antigen. Cancer Res 1994; 54: 1807-1811 ; PMID: 7511053
- 25 Troyer JK, Beckett ML, Wright GL. Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids. Int J Cancer 1995; 62: 552-558 ; PMID: 7665226
- 26 Wright GL, Grob BM, Haley C et al. Upregulation of prostate-specific membrane antigen after androgen-deprivation therapy. Urology 1996; 48: 326-334 ; PMID: 8753752
- 27 Sweat SD, Pacelli A, Murphy GP et al. Prostate-specific membrane antigen expression is greatest in prostate adenocarcinoma and lymph node metastases. Urology 1998; 52: 637-640 ;PMID: 9763084
- 28 Henry MD, Wen S, Silva MD et al. A prostate-specific membrane antigen-targeted monoclonal antibody-chemotherapeutic conjugate designed for the treatment of prostate cancer. Cancer Res 2004; 64: 7995-8001
- 29 Elsässer-Beile U, Reischl G, Wiehr S et al. PET imaging of prostate cancer xenografts with a highly specific antibody against the prostate-specific membrane antigen. J Nucl Med 2009; 50: 606-611
- 30 Milowsky MI, Nanus DM, Kostakoglu L et al. Phase I trial of yttrium-90-labeled anti-prostate-specific membrane antigen monoclonal antibody J591 for androgen-independent prostate cancer. J ClinOncol 2004; 22: 2522-2531
- 31 Barve A, Jin W, Cheng K. Prostate cancer relevant antigens and enzymes for targeted drug delivery. J Control Release 2014; 187: 118-132
- 32 Eder M, Schäfer M, Bauder-Wüst U et al. 68Ga-complex lipophilicity and the targeting property of a urea-based PSMA inhibitor for PET imaging. BioconjugChem 2012; 23: 688-697
- 33 Schäfer M, Bauder-Wüst U, Leotta K et al. A dimerized urea-based inhibitor of the prostate-specific membrane antigen for 68Ga-PET imaging of prostate cancer. EJNMMI Res 2012; 2: 23
- 34 Wright GL, Haley C, Beckett ML et al. Expression of prostate-specific membrane antigen in normal, benign, and malignant prostate tissues. Urologic Oncology: Seminars and Original Investigations 1995; 1: 18-28
- 35 Taneja SS. ProstaScint(R) Scan: Contemporary Use in Clinical Practice. Rev Urol 2004; 6: S19-S28 ; PMID: 16985928
- 36 Beheshti M, Kunit T, Haim S et al. BAY 1075553 PET-CT for Staging and Restaging Prostate Cancer Patients: Comparison with [18F] Fluorocholine PET-CT (Phase I Study). Mol Imaging Biol 2015; 17: 424-433
- 37 Ross JS, Sheehan CE, Fisher HAG et al. Correlation of primary tumor prostate-specific membrane antigen expression with disease recurrence in prostate cancer. Clin Cancer Res 2003; 9: 6357-6362 ; PMID: 14695135
- 38 Eder M, Eisenhut M, Babich J et al. PSMA as a target for radiolabelled small molecules. Eur J Nucl Med Mol Imaging 2013; 40: 819-823
- 39 DeGrado TR, Coleman RE, Wang S et al. Synthesis and evaluation of 18F-labeled choline as an oncologic tracer for positron emission tomography: initial findings in prostate cancer. Cancer Res 2001; 61: 110-117 ; PMID: 11196147
- 40 Hara T. C-Choline and 2-Deoxy-2-[F]Fluoro-D-Glucose in Tumor Imaging with Positron Emission Tomography. Molecular Imaging & Biology 2002; 4: 267-273
- 41 Schmid DT, John H, Zweifel R et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005; 235: 623-628
- 42 Igerc I, Kohlfürst S, Gallowitsch HJ et al. The value of 18F-choline PET/CT in patients with elevated PSA-level and negative prostate needle biopsy for localisation of prostate cancer. Eur J Nucl Med Mol Imaging 2008; 35: 976-983
- 43 Kwee SA, DeGrado T. Prostate biopsy guided by 18F-fluorocholine PET in men with persistently elevated PSA levels. Eur J Nucl Med Mol Imaging 2008; 35: 1567-1569 ; author reply 1570
- 44 Häcker A, Jeschke S, Leeb K et al. Detection of pelvic lymph node metastases in patients with clinically localized prostate cancer: comparison of [18F]fluorocholinepositron emission tomography-computerized tomography and laparoscopic radioisotope guided sentinel lymph node dissection. J Urol 2006; 176: 2014-2018
- 45 Husarik DB, Miralbell R, Dubs M et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 2008; 35: 253-263
- 46 Brogsitter C, Zöphel K, Kotzerke J. 18F-Choline, 11C-choline and 11C-acetate PET/CT: comparative analysis for imaging prostate cancer patients. Eur J Nucl Med Mol Imaging 2013; 40: S18-S27
- 47 Giovacchini G, Picchio M, Coradeschi E et al. Predictive factors of [(11)C]choline PET/CT in patients with biochemical failure after radical prostatectomy. Eur J Nucl Med Mol Imaging 2010; 37: 301-309
- 48 Rinnab L, Simon J, Hautmann RE et al. [(11)C]choline PET/CT in prostate cancer patients with biochemical recurrence after radical prostatectomy. World J Urol 2009; 27: 619-625
- 49 Cimitan M, Bortolus R, Morassut S et al. [18F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 2006; 33: 1387-1398
- 50 Pelosi E, Arena V, Skanjeti A et al. Role of whole-body 18F-choline PET/CT in disease detection in patients with biochemical relapse after radical treatment for prostate cancer. Radiol Med 2008; 113: 895-904
- 51 Heinisch M, Dirisamer A, Loidl W et al. Positron emission tomography/computed tomography with F-18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA 5 ng/ml?. Mol Imaging Biol 2006; 8: 43-48
- 52 Steiner C, Vees H, Zaidi H et al. Three-phase 18F-fluorocholine PET/CT in the evaluation of prostate cancer recurrence. Nuklearmedizin 2008; 48: 1-9
- 53 Vees H, Buchegger F, Albrecht S et al. 18F-choline and/or 11C-acetate positron emission tomography: detection of residual or progressive subclinical disease at very low prostate-specific antigen values (1 ng/mL) after radical prostatectomy. BJU Int 2007; 99: 1415-1420
- 54 Umbehr MH, Müntener M, Hany T et al. The role of 11C-choline and 18F-fluorocholine positron emission tomography (PET) and PET/CT in prostate cancer: a systematic review and meta-analysis. EurUrol 2013; 64: 106-117
- 55 Evangelista L, Cervino AR, Guttilla A et al. ¹⁸F-fluoromethylcholine or ¹⁸F-fluoroethylcholine pet for prostate cancer imaging: which is better? A literature revision. Nucl Med Biol 2015; 42: 340-348
- 56 Poulsen MH, Bouchelouche K, Høilund-Carlsen PF et al. [18F]fluoromethylcholine (FCH) positron emission tomography/computed tomography (PET/CT) for lymph node staging of prostate cancer: a prospective study of 210 patients. BJU Int 2012; 110: 1666-1671
- 57 Tilki D, Reich O, Graser A et al. 18F-Fluoroethylcholine PET/CT identifies lymph node metastasis in patients with prostate-specific antigen failure after radical prostatectomy but underestimates its extent. EurUrol 2013; 63: 792-796
- 58 Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF , Hrsg. Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms: Langversion 3.1. 2014 3 Aufl.
- 59 Picchio M, Briganti A, Fanti S et al. The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer. EurUrol 2011; 59: 51-60
- 60 Mottaghy FM, Behrendt FF, Verburg FA. (68)Ga-PSMA-HBED-CC PET/CT: where molecular imaging has an edge over morphological imaging. Eur J Nucl Med Mol Imaging 2015; 43: 394-396
- 61 Afshar-Oromieh A, Haberkorn U, Eder M et al. [68Ga]Gallium-labelled PSMA ligand as superior PET tracer for the diagnosis of prostate cancer: comparison with 18F-FECH. Eur J Nucl Med Mol Imaging 2012; 39: 1085-1086
- 62 Morigi JJ, Stricker PD, van Leeuwen PJ et al. Prospective Comparison of 18F-Fluoromethylcholine Versus 68Ga-PSMA PET/CT in Prostate Cancer Patients Who Have Rising PSA After Curative Treatment and Are Being Considered for Targeted Therapy. J Nucl Med 2015; 56: 1185-1190
- 63 Afshar-Oromieh A, Haberkorn U, Hadaschik B et al. PET/MRI with a 68Ga-PSMA ligand for the detection of prostate cancer. Eur J Nucl Med Mol Imaging 2013; 40: 1629-1630
- 64 Röthke MC, Afshar-Oromieh A, Schlemmer H. Potenziale der PET/MRT in der Diagnostik des Prostatakarzinoms. Radiologe 2013; 53: 676-681
- 65 Eiber M, Nekolla SG, Maurer T et al. (68)Ga-PSMA PET/MR with multimodality image analysis for primary prostate cancer. Abdom Imaging 2015; 40: 1769-1771
- 66 Afshar-Oromieh A, Haberkorn U, Schlemmer HP et al. Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labelled PSMA ligand for the diagnosis of recurrent prostate cancer: initial experience. Eur J Nucl Med Mol Imaging 2014; 41: 887-897
- 67 Weineisen M, Schottelius M, Simecek J et al. 68Ga- and 177Lu-Labeled PSMA I&T: Optimization of a PSMA-Targeted Theranostic Concept and First Proof-of-Concept Human Studies. J Nucl Med 2015; 56: 1169-1176
- 68 Budäus L, Leyh-Bannurah S, Salomon G et al. Initial Experience of (68)Ga-PSMA PET/CT Imaging in High-risk Prostate Cancer Patients Prior to Radical Prostatectomy. EurUrol 2016; 69: 393-396
- 69 Chakraborty PS, Tripathi M, Agarwal KK et al. Metastatic poorly differentiated prostatic carcinoma with neuroendocrine differentiation: negative on 68Ga-PSMA PET/CT. ClinNuclMed 2015; 40: e163-e166