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CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2024; 07(02): 121-147
DOI: 10.1055/s-0044-1786847
Review Article

Role of Ga68 Prostate-Specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Prostate Cancer Imaging

Jaykanth Amalachandran 
1   Department of Nuclear Medicine, PET-CT and Theranostics, Apollo Proton Cancer Centre, Taramani, Chennai, India
,
Thangalakshmi Sivathapandi
2   Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, United States
,
Gopinathraj Gunasekaran
1   Department of Nuclear Medicine, PET-CT and Theranostics, Apollo Proton Cancer Centre, Taramani, Chennai, India
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Abstract

The introduction of prostate-specific membrane antigen (PSMA) in clinical practice has revolutionized the evaluation of biochemical recurrence (BCR) of prostate cancer after curative-intent treatment. The high expression of this glycoprotein in prostate cancer cells makes PSMA imaging superior to the current conventional staging methods, namely bone scanning and computed tomography. The high capability of PSMA imaging for identifying very small previously undetected lesions has been widely demonstrated in the literature, leading to a rethinking of patient management by treating physicians. The usual and predictable patterns of spread in prostate cancer are still more prevalent, such as spread to pelvic lymph nodes and bone metastasis, but different patterns of disease spread are becoming more commonly recognized with higher reliability because PSMA imaging allows the detection of more usual and unusual lesions than conventional imaging. The expanding use of PSMA positron emission tomography (PET) has also revealed PSMA ligand uptake in diverse nonprostatic diseases, which raised questions about the specificity of this imaging modality. It is important for the reading physician to recognize and understand the usual disease spread, the most prevalent unusual sites of relapse, and the nonprostatic conditions which are PSMA avid not only to heighten the relevancy of reports but also to improve imaging consultancy in multispecialty oncologic practice. This article aims to brief the role of PSMA PET in the initial staging of multitude of clinical scenarios, BCR, castration-resistant prostate cancer, usual and unusual patterns of recurrence and metastatic spread diagnosed with PSMA PET, normal variants, pitfalls, and nonprostatic disorders showing PSMA expression.

Keywords

68Ga-PSMA - positron emission tomography - prostate cancer


Publication History

Article published online:
22 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Ferlay J, Shin HR, Bray F. et al. Lyon, France: International Agency for Research on Cancer. 2010. . GLOBOCAN 2008 v 1.2, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 10.
    Google Scholar
  • 2 Garcia M, Jemal A, Ward EM. et al. Global Cancer Facts and Figures 2007. Atlanta, GA: American Cancer Society; 2007
    Google Scholar
  • 3 Schaeffer E, Srinivas S, Antonarakis ES. et al. NCCN guidelines insights: prostate cancer, Version 1.2021. J Natl Compr Canc Netw 2021; 19 (02) 134-143
    CrossrefPubMedGoogle Scholar
  • 4 Jadvar H. Imaging evaluation of prostate cancer with 18F-fluorodeoxyglucose PET/CT: utility and limitations. Eur J Nucl Med Mol Imaging 2013; 40 (0 1, Suppl 1): S5-S10
    CrossrefPubMedGoogle Scholar
  • 5 Fanti S, Minozzi S, Castellucci P. et al. PET/CT with (11)C-choline for evaluation of prostate cancer patients with biochemical recurrence: meta-analysis and critical review of available data. Eur J Nucl Med Mol Imaging 2016; 43 (01) 55-69
    CrossrefPubMedGoogle Scholar
  • 6 Kim S-J, Lee SW. The role of 18F-fluciclovine PET in the management of prostate cancer: a systematic review and meta-analysis. Clin Radiol 2019; 74 (11) 886-892
    CrossrefPubMedGoogle Scholar
  • 7 Dietlein F, Kobe C, Neubauer S. et al. PSA-stratified performance of 18F- and 68Ga-PSMA PET in patients with biochemical recurrence of prostate cancer. J Nucl Med 2017; 58 (06) 947-952
    CrossrefPubMedGoogle Scholar
  • 8 Kuten J, Fahoum I, Savin Z. et al. Head-to-head comparison of 68Ga-PSMA-11 with 18F-PSMA-1007 PET/CT in staging prostate cancer using histopathology and immunohistochemical analysis as a reference standard. J Nucl Med 2020; 61 (04) 527-532
    CrossrefPubMedGoogle Scholar
  • 9 Fendler WP, Eiber M, Beheshti M. et al. 68Ga-PSMA PET/CT: joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging 2017; 44 (06) 1014-1024
    CrossrefPubMedGoogle Scholar
  • 10 Iravani A, Hofman MS, Mulcahy T. et al. 68Ga PSMA-11 PET with CT urography protocol in the initial staging and biochemical relapse of prostate cancer. Cancer Imaging 2017; 17 (01) 31
    CrossrefPubMedGoogle Scholar
  • 11 Guberina N, Hetkamp P, Ruebben H. et al. Whole-body integrated [68Ga]PSMA-11-PET/MR imaging in patients with recurrent prostate cancer: comparison with Whole-body PET/CT as the standard of reference. Mol Imaging Biol 2020; 22 (03) 788-796
    CrossrefPubMedGoogle Scholar
  • 12 Hofman MS, Lawrentschuk N, Francis RJ. et al; proPSMA Study Group Collaborators. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 2020; 395 (10231): 1208-1216
    CrossrefPubMedGoogle Scholar
  • 13 Lievens Y, Guckenberger M, Gomez D. et al. Defining oligometastatic disease from a radiation oncology perspective: an ESTRO-ASTRO consensus document. Radiother Oncol 2020; 148: 157-166
    CrossrefPubMedGoogle Scholar
  • 14 Aluwini SS, Mehra N, Lolkema MP. et al; Dutch Oligometastatic Prostate Cancer Working Group. Oligometastatic prostate cancer: results of a Dutch Multidisciplinary Consensus Meeting. Eur Urol Oncol 2020; 3 (02) 231-238
    CrossrefPubMedGoogle Scholar
  • 15 D'Angelillo RM, Francolini G, Ingrosso G. et al. Consensus statements on ablative radiotherapy for oligometastatic prostate cancer: a position paper of Italian Association of Radiotherapy and Clinical Oncology (AIRO). Crit Rev Oncol Hematol 2019; 138: 24-28
    CrossrefPubMedGoogle Scholar
  • 16 Lenis AT, Pooli A, Lec PM. et al. Prostate-specific membrane antigen positron emission tomography/computed tomography compared with conventional imaging for initial staging of treatment-naïve intermediate- and high-risk prostate cancer: a retrospective single-center study. Eur Urol Oncol 2020; ; (September): S25 88931120301395
    Google Scholar
  • 17 Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 1985; 312 (25) 1604-1608
    CrossrefPubMedGoogle Scholar
  • 18 Albertsen PC, Hanley JA, Barrows GH. et al. Prostate cancer and the Will Rogers phenomenon. J Natl Cancer Inst 2005; 97 (17) 1248-1253
    CrossrefPubMedGoogle Scholar
  • 19 National Comprehensive Cancer Networks. Prostate Cancer. NCCN.org. Accessed April 04, 2024 at: https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
    Google Scholar
  • 20 Evans MJ, Smith-Jones PM, Wongvipat J. et al. Noninvasive measurement of androgen receptor signaling with a positron-emitting radiopharmaceutical that targets prostate-specific membrane antigen. Proc Natl Acad Sci U S A 2011; 108 (23) 9578-9582
    CrossrefPubMedGoogle Scholar
  • 21 Hope TA, Truillet C, Ehman EC. et al. 68Ga-PSMA-11 PET imaging of response to androgen receptor inhibition: first human experience. J Nucl Med 2017; 58 (01) 81-84
    CrossrefPubMedGoogle Scholar
  • 22 Ettala O, Malaspina S, Tuokkola T. et al. Prospective study on the effect of short-term androgen deprivation therapy on PSMA uptake evaluated with 68Ga-PSMA-11 PET/MRI in men with treatment-naïve prostate cancer. Eur J Nucl Med Mol Imaging 2020; 47 (03) 665-673
    CrossrefPubMedGoogle Scholar
  • 23 Emmett L, Yin C, Crumbaker M. et al. Rapid modulation of PSMA expression by androgen deprivation: serial 68Ga-PSMA-11 PET in men with hormone-sensitive and castrate-resistant prostate cancer commencing androgen blockade. J Nucl Med 2019; 60 (07) 950-954
    CrossrefPubMedGoogle Scholar
  • 24 Hofman MS, Emmett L, Sandhu S. et al; TheraP Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. [177Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial. Lancet 2021; 397 (10276): 797-804
    CrossrefPubMedGoogle Scholar
  • 25 Kuo PH, Benson T, Messmann R, Groaning M. Why we did what we did: PSMA PET/CT selection criteria for the VISION trial. J Nucl Med 2022; 63 (06) 816-818
    CrossrefPubMedGoogle Scholar
  • 26 Pienta KJ, Gorin MA, Rowe SP. et al. A phase 2/3 prospective multicenter study of the diagnostic accuracy of prostate specific membrane antigen PET/CT with 18F-DCFPyL in prostate cancer patients (OSPREY). J Urol 2021; 206 (01) 52-61
    CrossrefPubMedGoogle Scholar
  • 27 Amin A, Blazevski A, Thompson J. et al. Protocol for the PRIMARY clinical trial, a prospective, multicentre, cross-sectional study of the additive diagnostic value of gallium-68 prostate-specific membrane antigen positron-emission tomography/computed tomography to multiparametric magnetic resonance imaging in the diagnostic setting for men being investigated for prostate cancer. BJU Int 2020; 125 (04) 515-524
    CrossrefPubMedGoogle Scholar
  • 28 Hope TA, Armstrong WR, Murthy V. et al. Accuracy of 68Ga-PSMA-11 for pelvic nodal metastasis detection prior to radical prostatectomy and pelvic lymph node dissection: a multicenter prospective phase III imaging study. J Clin Oncol 2020; 38 (15_suppl) 5502-5502
    CrossrefGoogle Scholar
  • 29 de Feria Cardet RE, Hofman MS, Segard T. et al. Is prostate-specific membrane antigen positron emission tomography/computed tomography imaging cost-effective in prostate cancer: an analysis informed by the proPSMA trial. Eur Urol 2021; 79 (03) 413-418
    CrossrefPubMedGoogle Scholar
  • 30 Ost P, Reynders D, Decaestecker K. et al. Surveillance or metastasis-directed therapy for oligometastatic prostate cancer recurrence: a prospective, randomized, multicenter phase II trial. J Clin Oncol 2018; 36 (05) 446-453
    CrossrefPubMedGoogle Scholar
  • 31 Phillips R, Shi WY, Deek M. et al. Outcomes of observation vs stereotactic ablative radiation for oligometastatic prostate cancer: the ORIOLE phase 2 randomized clinical trial. JAMA Oncol 2020; 6 (05) 650-659
    CrossrefPubMedGoogle Scholar
  • 32 Mullins JK, Feng Z, Trock BJ, Epstein JI, Walsh PC, Loeb S. The impact of anatomical radical retropubic prostatectomy on cancer control: the 30-year anniversary. J Urol 2012; 188 (06) 2219-2224
    CrossrefPubMedGoogle Scholar
  • 33 Cookson MS, Aus G, Burnett AL. et al. Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol 2007; 177 (02) 540-545
    CrossrefPubMedGoogle Scholar
  • 34 Roach III M, Hanks G, Thames Jr H. et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 2006; 65 (04) 965-974
    CrossrefPubMedGoogle Scholar
  • 35 Calais J, Ceci F, Eiber M. et al. 18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial. Lancet Oncol 2019; 20 (09) 1286-1294
    CrossrefPubMedGoogle Scholar
  • 36 Fendler WP, Calais J, Eiber M. et al. Assessment of 68Ga-PSMA-11 PET accuracy in localizing recurrent prostate cancer: a prospective single-arm clinical trial. JAMA Oncol 2019; 5 (06) 856-863
    CrossrefPubMedGoogle Scholar
  • 37 Morris MJ, Rowe SP, Gorin MA. et al; CONDOR Study Group. Diagnostic performance of 18F-DCFPyL-PET/CT in men with biochemically recurrent prostate cancer: results from the CONDOR phase III, multicenter study. Clin Cancer Res 2021; 27 (13) 3674-3682
    CrossrefPubMedGoogle Scholar
  • 38 Fendler WP, Ferdinandus J, Czernin J. et al. Impact of 68Ga-PSMA-11 PET on the management of recurrent prostate cancer in a prospective single-arm clinical trial. J Nucl Med 2020; 61 (12) 1793-1799
    CrossrefPubMedGoogle Scholar
  • 39 Calais J, Fendler WP, Eiber M. et al. Impact of 68Ga-PSMA-11 PET/CT on the management of prostate cancer patients with biochemical recurrence. J Nucl Med 2018; 59 (03) 434-441
    CrossrefPubMedGoogle Scholar
  • 40 Han S, Woo S, Kim YJ, Suh CH. Impact of 68Ga-PSMA PET on the management of patients with prostate cancer: a systematic review and meta-analysis. Eur Urol 2018; 74 (02) 179-190
    CrossrefPubMedGoogle Scholar
  • 41 Trabulsi EJ, Rumble RB, Jadvar H. et al. Optimum imaging strategies for advanced prostate cancer: ASCO guideline. J Clin Oncol 2020; 38 (17) 1963-1996
    CrossrefPubMedGoogle Scholar
  • 42 Froemming AT, Verma S, Eberhardt SC. et al; Expert Panel on Urologic Imaging. ACR Appropriateness Criteria® post-treatment follow-up prostate cancer. J Am Coll Radiol 2018; 15 (5S): S132-S149
    CrossrefPubMedGoogle Scholar
  • 43 Fendler WP, Weber M, Iravani A. et al. Prostate-specific membrane antigen ligand positron emission tomography in men with nonmetastatic castration-resistant prostate cancer. Clin Cancer Res 2019; 25 (24) 7448-7454
    CrossrefPubMedGoogle Scholar
  • 44 Triggiani L, Alongi F, Buglione M. et al. Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study. Br J Cancer 2017; 116 (12) 1520-1525
    CrossrefPubMedGoogle Scholar
  • 45 Sartor O, de Bono J, Chi KN. et al; VISION Investigators. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med 2021; 385 (12) 1091-1103
    CrossrefPubMedGoogle Scholar
  • 46 Aggarwal R, Wei X, Kim W. et al. Heterogeneous flare in prostate-specific membrane antigen positron emission tomography tracer uptake with initiation of androgen pathway blockade in metastatic prostate cancer. Eur Urol Oncol 2018; 1 (01) 78-82
    CrossrefPubMedGoogle Scholar
  • 47 National Comprehensive Cancer Network. Prostate cancer (version 2.2017). Plymouth Meeting, Pa: National Comprehensive Cancer Network, 2017
    PubMedGoogle Scholar
  • 48 Sanda MG, Cadeddu JA, Kirkby E. et al. Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. I. Risk stratification, shared decision making, and care options. J Urol 2018; 199 (03) 683-690
    CrossrefPubMedGoogle Scholar
  • 49 Shipley WU, Seiferheld W, Lukka HR. et al; NRG Oncology RTOG. Radiation with or without antiandrogen therapy in recurrent prostate cancer. N Engl J Med 2017; 376 (05) 417-428
    CrossrefPubMedGoogle Scholar
  • 50 Lilja H, Ulmert D, Vickers AJ. Prostate-specific antigen and prostate cancer: prediction, detection and monitoring. Nat Rev Cancer 2008; 8 (04) 268-278
    CrossrefPubMedGoogle Scholar
  • 51 Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999; 281 (17) 1591-1597
    CrossrefPubMedGoogle Scholar
  • 52 Wibmer AG, Burger IA, Sala E, Hricak H, Weber WA, Vargas HA. Molecular imaging of prostate cancer. Radiographics 2016; 36 (01) 142-159
    CrossrefPubMedGoogle Scholar
  • 53 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 (02) 197-209
    CrossrefPubMedGoogle Scholar
  • 54 Hofman MS, Hicks RJ, Maurer T, Eiber M. Prostate specific membrane antigen PET: clinical utility in prostate cancer—normal patterns, pearls, and pitfalls. Radiographics 2018; 38 (01) 200-217
    CrossrefPubMedGoogle Scholar
  • 55 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 (05) 668-674
    CrossrefPubMedGoogle Scholar
  • 56 Dureja S, Thakral P, Pant V, Sen I. Rare sites of metastases in prostate cancer detected on Ga-68 PSMA PET/CT scan: a case series. Indian J Nucl Med 2017; 32 (01) 13-15
    CrossrefPubMedGoogle Scholar
  • 57 Hijazi S, Meller B, Leitsmann C. et al. See the unseen: mesorectal lymph node metastases in prostate cancer. Prostate 2016; 76 (08) 776-780
    CrossrefPubMedGoogle Scholar
  • 58 Cirillo S, Petracchini M, Scotti L. et al. Endorectal magnetic resonance imaging at 1.5 Tesla to assess local recurrence following radical prostatectomy using T2-weighted and contrast-enhanced imaging. Eur Radiol 2009; 19 (03) 761-769
    CrossrefPubMedGoogle Scholar
  • 59 Sella T, Schwartz LH, Swindle PW. et al. Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 2004; 231 (02) 379-385
    CrossrefPubMedGoogle Scholar
  • 60 Uprimny C, Kroiss AS, Fritz J. et al. Early PET imaging with [68]Ga-PSMA-11 increases the detection rate of local recurrence in prostate cancer patients with biochemical recurrence. Eur J Nucl Med Mol Imaging 2017; 44 (10) 1647-1655
    CrossrefPubMedGoogle Scholar
  • 61 Freitag MT, Radtke JP, Afshar-Oromieh A. et al. Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in 68Ga-PSMA-11-PET of PET/CT and PET/MRI: comparison with mpMRI integrated in simultaneous PET/MRI. Eur J Nucl Med Mol Imaging 2017; 44 (05) 776-787
    CrossrefPubMedGoogle Scholar
  • 62 Ellis CL, Epstein JI. Metastatic prostate adenocarcinoma to the penis: a series of 29 cases with predilection for ductal adenocarcinoma. Am J Surg Pathol 2015; 39 (01) 67-74
    CrossrefPubMedGoogle Scholar
  • 63 Raleigh DR, Hsu IC, Braunstein S, Chang AJ, Simko JP, Roach III M. Bladder wall recurrence of prostate cancer after high-dose-rate brachytherapy. Brachytherapy 2015; 14 (02) 185-188
    CrossrefPubMedGoogle Scholar
  • 64 Bowrey DJ, Otter MI, Billings PJ. Rectal infiltration by prostatic adenocarcinoma: report on six patients and review of the literature. Ann R Coll Surg Engl 2003; 85 (06) 382-385
    CrossrefPubMedGoogle Scholar
  • 65 Lazarus JA. Complete rectal occlusion necessitating colostomy due to carcinoma of the prostate. Am J Surg 1935; 30 (03) 502-505
    CrossrefGoogle Scholar
  • 66 Murray SK, Breau RH, Guha AK, Gupta R. Spread of prostate carcinoma to the perirectal lymph node basin: analysis of 112 rectal resections over a 10-year span for primary rectal adenocarcinoma. Am J Surg Pathol 2004; 28 (09) 1154-1162
    CrossrefPubMedGoogle Scholar
  • 67 Vaghefi H, Magi-Galluzzi C, Klein EA. Local recurrence of prostate cancer in rectal submucosa after transrectal needle biopsy and radical prostatectomy. Urology 2005; 66 (04) 881
    CrossrefPubMedGoogle Scholar
  • 68 Hruby G, Eade T, Kneebone A. et al. Delineating biochemical failure with 68Ga-PSMA-PET following definitive external beam radiation treatment for prostate cancer. Radiother Oncol 2017; 122 (01) 99-102
    CrossrefPubMedGoogle Scholar
  • 69 Einspieler I, Rauscher I, Düwel C. et al. Detection efficacy of hybrid 68Ga-PSMA ligand PET/CT in prostate cancer patients with biochemical recurrence after primary radiation therapy defined by Phoenix criteria. J Nucl Med 2017; 58 (07) 1081-1087
    CrossrefPubMedGoogle Scholar
  • 70 Cellini N, Morganti AG, Mattiucci GC. et al. Analysis of intraprostatic failures in patients treated with hormonal therapy and radiotherapy: implications for conformal therapy planning. Int J Radiat Oncol Biol Phys 2002; 53 (03) 595-599
    CrossrefPubMedGoogle Scholar
  • 71 Saitoh H, Yoshida K, Uchijima Y, Kobayashi N, Suwata J, Kamata S. Two different lymph node metastatic patterns of a prostatic cancer. Cancer 1990; 65 (08) 1843-1846
    CrossrefPubMedGoogle Scholar
  • 72 Bubendorf L, Schöpfer A, Wagner U. et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol 2000; 31 (05) 578-583
    CrossrefPubMedGoogle Scholar
  • 73 Maurer T, Gschwend JE, Rauscher I. et al. Diagnostic efficacy of (68) Gallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer. J Urol 2016; 195 (05) 1436-1443
    CrossrefPubMedGoogle Scholar
  • 74 Bader P, Burkhard FC, Markwalder R, Studer UE. Is a limited lymph node dissection an adequate staging procedure for prostate cancer?. J Urol 2002; 168 (02) 514-518 , discussion 518
    CrossrefPubMedGoogle Scholar
  • 75 Paño B, Sebastià C, Buñesch L. et al. Pathways of lymphatic spread in male urogenital pelvic malignancies. Radiographics 2011; 31 (01) 135-160
    CrossrefPubMedGoogle Scholar
  • 76 Buyyounouski MK, Choyke PL, McKenney JK. et al. Prostate cancer: major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017; 67 (03) 245-253
    CrossrefPubMedGoogle Scholar
  • 77 Griffin N, Burke C, Grant LA. Common primary tumours of the abdomen and pelvis and their patterns of tumour spread as seen on multi-detector computed tomography. Insights Imaging 2011; 2 (03) 205-214
    CrossrefPubMedGoogle Scholar
  • 78 Briganti A, Suardi N, Capogrosso P. et al. Lymphatic spread of nodal metastases in high-risk prostate cancer: The ascending pathway from the pelvis to the retroperitoneum. Prostate 2012; 72 (02) 186-192
    CrossrefPubMedGoogle Scholar
  • 79 Heck MM, Souvatzoglou M, Retz M. et al. Prospective comparison of computed tomography, diffusion-weighted magnetic resonance imaging and [11C]choline positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer patients. Eur J Nucl Med Mol Imaging 2014; 41 (04) 694-701
    CrossrefPubMedGoogle Scholar
  • 80 Vinjamoori AH, Jagannathan JP, Shinagare AB. et al. Atypical metastases from prostate cancer: 10-year experience at a single institution. AJR Am J Roentgenol 2012; 199 (02) 367-372
    CrossrefPubMedGoogle Scholar
  • 81 Gakis G, Boorjian SA, Briganti A. et al. The role of radical prostatectomy and lymph node dissection in lymph node-positive prostate cancer: a systematic review of the literature. Eur Urol 2014; 66 (02) 191-199
    CrossrefPubMedGoogle Scholar
  • 82 Heck MM, Retz M, Bandur M. et al. Topography of lymph node metastases in prostate cancer patients undergoing radical prostatectomy and extended lymphadenectomy: results of a combined molecular and histopathologic mapping study. Eur Urol 2014; 66 (02) 222-229
    CrossrefPubMedGoogle Scholar
  • 83 Rauscher I, Maurer T, Beer AJ. et al. Value of 68GaPSMA HBED-CC PET for the assessment of lymph node metastases in prostate cancer patients with biochemical recurrence: comparison with histopathology after salvage lymphadenectomy. J Nucl Med 2016; 57 (11) 1713-1719
    CrossrefPubMedGoogle Scholar
  • 84 Hope TA, Aggarwal R, Chee B. et al. Impact of 68GaPSMA-11 PET on management in patients with biochemically recurrent prostate cancer. J Nucl Med 2017; 58 (12) 1956-1961
    CrossrefPubMedGoogle Scholar
  • 85 Hövels AM, Heesakkers RAM, Adang EM. et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol 2008; 63 (04) 387-395
    CrossrefPubMedGoogle Scholar
  • 86 van Leeuwen PJ, Emmett L, Ho B. et al. Prospective evaluation of 68Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer. BJU Int 2017; 119 (02) 209-215
    CrossrefPubMedGoogle Scholar
  • 87 Jilg CA, Drendel V, Rischke HC. et al. Diagnostic accuracy of Ga-68-HBED-CC-PSMA-ligand-PET/CT before salvage lymph node dissection for recurrent prostate cancer. Theranostics 2017; 7 (06) 1770-1780
    CrossrefPubMedGoogle Scholar
  • 88 Long MA, Husband JE. Features of unusual metastases from prostate cancer. Br J Radiol 1999; 72 (862) 933-941
    CrossrefPubMedGoogle Scholar
  • 89 Mohler JL, Armstrong AJ, Bahnson RR. et al. Prostate cancer, version 1.2016. J Natl Compr Canc Netw 2016; 14 (01) 19-30
    CrossrefPubMedGoogle Scholar
  • 90 Perera M, Papa N, Christidis D. et al. Sensitivity, specificity, and predictors of positive 68Ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: a systematic review and meta-analysis. Eur Urol 2016; 70 (06) 926-937
    CrossrefPubMedGoogle Scholar
  • 91 Gandaglia G, Abdollah F, Schiffmann J. et al. Distribution of metastatic sites in patients with prostate cancer: a population-based analysis. Prostate 2014; 74 (02) 210-216
    CrossrefPubMedGoogle Scholar
  • 92 Lange MB, Nielsen ML, Andersen JD, Lilholt HJ, Vyberg M, Petersen LJ. Diagnostic accuracy of imaging methods for the diagnosis of skeletal malignancies: a retrospective analysis against a pathology-proven reference. Eur J Radiol 2016; 85 (01) 61-67
    CrossrefPubMedGoogle Scholar
  • 93 Janssen JC, Woythal N, Meißner S. et al. [68Ga] PSMAHBED-CC uptake in osteolytic, osteoblastic, and bone marrow metastases of prostate cancer patients. Mol Imaging Biol 2017; 19 (06) 933-943
    CrossrefPubMedGoogle Scholar
  • 94 Saitoh H, Hida M, Shimbo T, Nakamura K, Yamagata J, Satoh T. Metastatic patterns of prostatic cancer. Correlation between sites and number of organs involved. Cancer 1984; 54 (12) 3078-3084
    CrossrefPubMedGoogle Scholar
  • 95 Calais J, Czernin J, Cao M. et al. 68Ga-PSMA-11 PET/ CT mapping of prostate cancer biochemical recurrence after radical prostatectomy in 270 patients with a PSA level of less than 1.0 ng/mL: impact on salvage radiotherapy planning. J Nucl Med 2018; 59 (02) 230-237
    CrossrefPubMedGoogle Scholar
  • 96 Werner RA, Andree C, Javadi MS. et al. A voice from the past: rediscovering the Virchow node with prostate-specific membrane antigen-targeted 18F-DCFPyL positron emission tomography imaging. Urology 2018; 117: 18-21
    CrossrefPubMedGoogle Scholar
  • 97 Osman MM, Iravani A, Hicks RJ, Hofman MS. Detection of synchronous primary malignancies with 68Ga-labeled prostate-specific membrane antigen PET/CT in patients with prostate cancer: frequency in 764 patients. J Nucl Med 2017; 58 (12) 1938-1942
    CrossrefPubMedGoogle Scholar
  • 98 Chang SS, O'Keefe DS, Bacich DJ, Reuter VE, Heston WD, Gaudin PB. Prostate-specific membrane antigen is produced in tumor-associated neovasculature. Clin Cancer Res 1999; 5 (10) 2674-2681
    PubMedGoogle Scholar
  • 99 Rosenzweig B, Haramaty R, Davidson T. et al. Very low prostate PET/CT PSMA uptake may be misleading in staging radical prostatectomy candidates. J Pers Med 2022; 12 (03) 410
    CrossrefPubMedGoogle Scholar
  • 100 Afshar-Oromieh A, Holland-Letz T, Giesel FL. et al. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J Nucl Med Mol Imaging 2017; 44 (08) 1258-1268
    CrossrefPubMedGoogle Scholar
  • 101 Ross JS, Sheehan CE, Fisher HA. et al. Correlation of primary tumor prostate-specific membrane antigen expression with disease recurrence in prostate cancer. Clin Cancer Res 2003; 9 (17) 6357-6362
    PubMedGoogle Scholar
  • 102 Watts K, Li J, Magi-Galluzzi C, Zhou M. Incidence and clinicopathological characteristics of intraductal carcinoma detected in prostate biopsies: a prospective cohort study. Histopathology 2013; 63 (04) 574-579
    CrossrefPubMedGoogle Scholar
  • 103 Morgan TM, Welty CJ, Vakar-Lopez F, Lin DW, Wright JL. Ductal adenocarcinoma of the prostate: increased mortality risk and decreased serum prostate specific antigen. J Urol 2010; 184 (06) 2303-2307
    CrossrefPubMedGoogle Scholar
  • 104 Ranasinha N, Omer A, Philippou Y. et al. Ductal adenocarcinoma of the prostate: a systematic review and meta-analysis of incidence, presentation, prognosis, and management. BJUI Compass 2021; 2 (01) 13-23
    CrossrefPubMedGoogle Scholar
  • 105 McEwan LM, Wong D, Yaxley J. Flourodeoxyglucose positron emission tomography scan may be helpful in the case of ductal variant prostate cancer when prostate specific membrane antigen ligand positron emission tomography scan is negative. J Med Imaging Radiat Oncol 2017; 61 (04) 503-505
    CrossrefPubMedGoogle Scholar
  • 106 Backhaus P, Noto B, Avramovic N. et al. Targeting PSMA by radioligands in non-prostate disease-current status and future perspectives. Eur J Nucl Med Mol Imaging 2018; 45 (05) 860-877
    CrossrefPubMedGoogle Scholar
  • 107 Malik D, Kumar R, Mittal BR, Singh H, Bhattacharya A, Singh SK. 68Ga-labeled PSMA uptake in nonprostatic malignancies: has the time come to remove “PS” from PSMA?. Clin Nucl Med 2018; 43 (07) 529-532
    CrossrefPubMedGoogle Scholar
  • 108 Rizzo A, Dall'Armellina S, Pizzuto DA. et al. PSMA radioligand uptake as a biomarker of neoangiogenesis in solid tumours: diagnostic or theragnostic factor?. Cancers (Basel) 2022; 14 (16) 4039
    CrossrefPubMedGoogle Scholar
  • 109 Hermann RM, Djannatian M, Czech N, Nitsche M. Prostate-specific membrane antigen PET/CT: false-positive results due to sarcoidosis?. Case Rep Oncol 2016; 9 (02) 457-463
    CrossrefPubMedGoogle Scholar
  • 110 Jadvar H, Ballas LK. PSMA PET: transformational change in prostate cancer management?. J Nucl Med 2018; 59 (02) 228-229
    CrossrefPubMedGoogle Scholar
  • 111 Gorin MA, Rowe SP, Denmeade SR. Clinical applications of molecular imaging in the management of prostate cancer. PET Clin 2017; 12 (02) 185-192
    CrossrefPubMedGoogle Scholar
  • 112 Herlemann A, Wenter V, Kretschmer A. et al. 68Ga-PSMA positron emission tomography/computed tomography provides accurate staging of lymph node regions prior to lymph node dissection in patients with prostate cancer. Eur Urol 2016; 70 (04) 553-557
    CrossrefPubMedGoogle Scholar
  • 113 Wallitt KL, Khan SR, Dubash S, Tam HH, Khan S, Barwick TD. Clinical PET imaging in prostate cancer. Radiographics 2017; 37 (05) 1512-1536
    CrossrefPubMedGoogle Scholar
  • 114 Vargas HA, Wassberg C, Akin O, Hricak H. MR imaging of treated prostate cancer. Radiology 2012; 262 (01) 26-42
    CrossrefPubMedGoogle Scholar
  • 115 Pyka T, Okamoto S, Dahlbender M. et al. Comparison of bone scintigraphy and 68Ga-PSMA PET for skeletal staging in prostate cancer. Eur J Nucl Med Mol Imaging 2016; 43 (12) 2114-2121
    CrossrefPubMedGoogle Scholar
  • 116 Schirrmeister H, Glatting G, Hetzel J. et al. Prospective evaluation of the clinical value of planar bone scans, SPECT, and (18)F-labeled NaF PET in newly diagnosed lung cancer. J Nucl Med 2001; 42 (12) 1800-1804
    PubMedGoogle Scholar
  • 117 Thomas L, Balmus C, Ahmadzadehfar H, Essler M, Strunk H, Bundschuh RA. Assessment of bone metastases in patients with prostate cancer: a comparison between 99mTc-bone-scintigraphy and 68Ga-PSMA PET/CT. Pharmaceuticals (Basel) 2017; 10 (03) 68
    CrossrefPubMedGoogle Scholar
  • 118 Janssen JC, Meißner S, Woythal N. et al. Comparison of hybrid 68Ga-PSMA-PET/CT and 99mTc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: additional value of morphologic information from low dose CT. Eur Radiol 2018; 28 (02) 610-619
    CrossrefPubMedGoogle Scholar
  • 119 Tulsyan S, Das CJ, Tripathi M, Seth A, Kumar R, Bal C. Comparison of 68Ga-PSMA PET/CT and multiparametric MRI for staging of high-risk prostate cancer68Ga-PSMA PET and MRI in prostate cancer. Nucl Med Commun 2017; 38 (12) 1094-1102
    CrossrefPubMedGoogle Scholar
  • 120 Baumann R, Koncz M, Luetzen U, Krause F, Dunst J. Oligometastases in prostate cancer: metabolic response in follow-up PSMA-PET-CTs after hypofractionated IGRT. Strahlenther Onkol 2018; 194 (04) 318-324
    CrossrefPubMedGoogle Scholar
  • 121 Ballas LK, de Castro Abreu AL, Quinn DI. What medical, urologic, and radiation oncologists want from molecular imaging of prostate cancer. J Nucl Med 2016; 57 (Suppl. 03) 6S-12S
    CrossrefPubMedGoogle Scholar