PET Imaging for Prostate Cancer

Radiol Clin North Am. 2021 Sep;59(5):801-811. doi: 10.1016/j.rcl.2021.05.008.

Abstract

The role of PET imaging with 11C-choline and 18F-fluciclovine in evaluating patients with prostate cancer (PCa) has become more important over the years and has been incorporated into the NCCN guidelines. A new generation of PET radiotracers targeting the prostate-specific membrane antigen (PSMA) is widely used outside the United States to evaluate patients with primary PCa and PCa recurrence. PET imaging influences treatment planning and demonstrates a significantly higher disease detection rate than conventional imaging such as computed tomography and MR imaging. Early data indicate that using PET radiotracers such as 18F-fluciclovine and PSMA improves patient outcomes. 68-Ga-PSMA-11 and 18F-DCFPyL-PET/CT were recently approved by the US Food & Drug Administration (FDA) for clinical use. Other PSMA radiotracers, including fluorinated variants, will likely gain FDA approval in the not-too-distant future.

Keywords: Biochemical recurrence; Fluciclovine; PET imaging; Prostate cancer; Prostate-specific membrane antigen; Theranostics.

Publication types

  • Review

MeSH terms

  • Carboxylic Acids
  • Cyclobutanes
  • Humans
  • Male
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography / trends*
  • Prostate-Specific Antigen
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology*
  • Radiopharmaceuticals

Substances

  • Carboxylic Acids
  • Cyclobutanes
  • Radiopharmaceuticals
  • fluciclovine F-18
  • Prostate-Specific Antigen