PET of Glucose Metabolism and Cellular Proliferation in Prostate Cancer.
Imaging of the Warburg effect, which is the principal but not the sole cause for enhanced glucose metabolism in tumors, with PET and18F-FDG has become the mainstay for the imaging evaluation of several cancers. Despite the seemingly prevalent notion that18F-FDG PET may not be useful in prostate cancer, relatively limited evidence suggests that this imaging modality can be useful for the evaluation of the extent of metastatic disease and the assessment of the therapy response and prognosis in men with castration-resistant prostate cancer. Incidental high focal18F-FDG uptake in the prostate gland, although generally rare, may also indicate occult prostate cancer that may need to be further scrutinized. In general,18F-FDG PET is not useful for initial staging and is of limited utility in the clinical setting of biochemical failure after prior definitive therapy for primary cancer. Although more experience is needed, it appears that the imaging of cellular proliferation with PET and 3'-deoxy-3'-18F-fluorothymidine or 2'-18F-fluoro-5-methyl-1-β-d-arabinofuranosyluracil may also allow for targeted biopsy and localization for focal therapy of aggressive prostate tumors as well as assessment of the therapy response to various standard and novel treatment regimens in patients with metastatic disease.
Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, California jadvar@med.usc.edu.
Hossein
H
Jadvar
D014408:Biomarkers, Tumor / Q000378:metabolism; D049109:Cell Proliferation; D019317:Evidence-Based Medicine; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D057054:Molecular Imaging / Q000379:methods; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics
D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose
18F-FDG; 18F-FLT; 18F-FMAU; PET; PET/CT; prostate cancer
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