The Evolving Role of 18F-FDG PET/CT in Diagnosis and Prognosis Prediction in Progressive Prostate Cancer

Kai Shen; Bo Liu; Xiang Zhou; Yiyi Ji; Lei Chen; Qi Wang; Wei Xue

doi:10.3389/fonc.2021.683793

The Evolving Role of ¹⁸F-FDG PET/CT in Diagnosis and Prognosis Prediction in Progressive Prostate Cancer

Front Oncol. 2021 Jul 29:11:683793. doi: 10.3389/fonc.2021.683793. eCollection 2021.

Authors

Kai Shen¹, Bo Liu¹, Xiang Zhou², Yiyi Ji¹, Lei Chen¹, Qi Wang¹, Wei Xue¹

Affiliations

¹ State Key Laboratory of Oncogenes and Related Genes, Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Positron emission tomography/computed tomography (PET/CT) is widely used in prostate cancer to evaluate the localized tumor burden and detect symptomatic metastatic lesions early. ¹⁸F-FDG is the most used tracer for oncologic imaging, but it has limitations in detecting early-stage prostate cancer. ⁶⁸Ga-PSMA is a new tracer that has high specificity and sensibility in detecting local and metastatic tumors. But with the progression of prostate cancer, the enhancement of glucose metabolism in progressive prostate cancer provides a chance for ¹⁸F-FDG. This review focuses on PET/CT in the detection and prognosis of prostate cancer, summarizing the literature on ¹⁸F-FDG and ⁶⁸Ga-PSMA in prostate cancer and highlighting that ¹⁸F-FDG has advantages in detecting local recurrence, visceral and lymph node metastases compared to ⁶⁸Ga-PSMA in partial progressive prostate cancer and castration-resistant prostate cancer patients. We emphasize ¹⁸F-FDG PET/CT can compensate for the weakness of ⁶⁸Ga-PSMA PET/CT in progressive prostate cancer.

Keywords: 18F-FDG; 68Ga-PSMA; PET/CT; glucose metabolism; prostate cancer.