title: Current use of PSMA-PET in prostate cancer management.
abstract: Currently, the findings of imaging procedures used for detection or staging of prostate cancer depend on morphology of lymph nodes or bone metabolism and do not always meet diagnostic needs. Prostate-specific membrane antigen (PSMA), a transmembrane protein that has considerable overexpression on most prostate cancer cells, has gained increasing interest as a target molecule for imaging. To date, several small compounds for labelling PSMA have been developed and are currently being investigated as imaging probes for PET with the (68)Ga-labelled PSMA inhibitor Glu-NH-CO-NH-Lys(Ahx)-HBED-CC being the most widely studied agent. (68)Ga-PSMA-PET imaging in combination with multiparametric MRI (mpMRI) might provide additional molecular information on cancer localization within the prostate. In patients with primary prostate cancer of intermediate-risk to high-risk, PSMA-based imaging has been reported to improve detection of metastatic disease compared with CT or mpMRI, rendering additional cross-sectional imaging or bone scintigraphy unnecessary. Furthermore, in patients with biochemically recurrent prostate cancer, use of (68)Ga-PSMA-PET imaging has been shown to increase detection of metastatic sites, even at low serum PSA values, compared with conventional imaging or PET examination with different tracers. Thus, although current knowledge is still limited and derived mostly from retrospective series, PSMA-based imaging holds great promise to improve prostate cancer management.
authors.affiliation: Department of Urology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81671 Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81671 Munich, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Eiber
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81671 Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.affiliation: Department of Urology, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81671 Munich, Germany.
authors.forename: Jürgen E
authors.initials: JE
authors.lastname: Gschwend
mesh_terms: D000818:Animals; D000954:Antigens, Surface / Q000032:analysis / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism*; D019468:Disease Management; D043425:Glutamate Carboxypeptidase II / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*
chemical_list: D000954:Antigens, Surface; D014408:Biomarkers, Tumor; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II