Prostate cancer (PCa) provides different types of approach, both as regards the diagnostic and therapeutic aspects, based on the stage of disease. Nowadays, multi-parametric MRI (mpMRI) plays a pivotal role in primary prostate cancer diagnosis and opens the door to the planning of therapeutic st In this fields, conventional morphological imaging showed limited accuracy for assessment of biochemical recurrent prostate cancer (BRPCa), advanced disease and post-therapy monitoring and evaluations. Nuclear medicine has a metabolic or receptor point of view that is often helpful in situations where morphological analysis is not enough. Radiolabeled choline (11C or 18F), base its use on the exalted neoplastic cell membranes turnover and phosphatidylcholine production increase. Thanks to its features, 68Ga-PSMA PET imaging is affirming in entire PCa diagnostic scenario: from local recurrence and advanced disease to primary tumor localization and lymph nodes disease detection; up to the most future-oriented applications that include radio guided surgery (RGS) and theranostics with 177Lu-PSMA. Having achieved excellent levels of diagnostic accuracy does not stop nuclear medicine research which for these comparison scenarios today also proposes the use of 11C-acetate and 18-Fluciclovine that undermine choline PET/CT and PSMA PET/CT results, in a race for the best possible diagnostic performance. Nuclear medicine is also very active in the study of “bone scenario”, it represent an essential evaluation for correct defining the disease stage. As for diagnostics, also in the therapy’s field we observe the flowering of new solutions, to try to improve both the survival and the quality of life of the patient: 223Ra-dichloride and 177Lu-PSMA are two of the most brilliant examples. Finally, the look towards the future cannot ignore the advent of hybrid systems; from this point of view the diamond shining in the near future undoubtedly seems to be PET/MRI, fixing the maximum anatomical definition with finest metabolic-receptor informations.
Nuclear medicine in prostate cancer relapse and biochemical recurrence
Cuccurullo V.Conceptualization
2021
Abstract
Prostate cancer (PCa) provides different types of approach, both as regards the diagnostic and therapeutic aspects, based on the stage of disease. Nowadays, multi-parametric MRI (mpMRI) plays a pivotal role in primary prostate cancer diagnosis and opens the door to the planning of therapeutic st In this fields, conventional morphological imaging showed limited accuracy for assessment of biochemical recurrent prostate cancer (BRPCa), advanced disease and post-therapy monitoring and evaluations. Nuclear medicine has a metabolic or receptor point of view that is often helpful in situations where morphological analysis is not enough. Radiolabeled choline (11C or 18F), base its use on the exalted neoplastic cell membranes turnover and phosphatidylcholine production increase. Thanks to its features, 68Ga-PSMA PET imaging is affirming in entire PCa diagnostic scenario: from local recurrence and advanced disease to primary tumor localization and lymph nodes disease detection; up to the most future-oriented applications that include radio guided surgery (RGS) and theranostics with 177Lu-PSMA. Having achieved excellent levels of diagnostic accuracy does not stop nuclear medicine research which for these comparison scenarios today also proposes the use of 11C-acetate and 18-Fluciclovine that undermine choline PET/CT and PSMA PET/CT results, in a race for the best possible diagnostic performance. Nuclear medicine is also very active in the study of “bone scenario”, it represent an essential evaluation for correct defining the disease stage. As for diagnostics, also in the therapy’s field we observe the flowering of new solutions, to try to improve both the survival and the quality of life of the patient: 223Ra-dichloride and 177Lu-PSMA are two of the most brilliant examples. Finally, the look towards the future cannot ignore the advent of hybrid systems; from this point of view the diamond shining in the near future undoubtedly seems to be PET/MRI, fixing the maximum anatomical definition with finest metabolic-receptor informations.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
