4.6 Review

Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives

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Article Radiology, Nuclear Medicine & Medical Imaging

PSMA PET/CT: joint EANM procedure guideline/SNMMI procedure standard for prostate cancer imaging 2.0

Wolfgang P. Fendler et al.

Summary: This article aims to provide updated guidance and standards for the use of PSMA PET/CT in imaging prostate cancer. It discusses procedures and characteristics of various PSMA small radioligands and different clinical scenarios for their use. The document is intended to support clinicians and technicians in implementing PSMA PET/CT imaging in both research and routine practice.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2023)

Article Pathology

Combination of [68Ga]Ga-PSMA PET/CT and [18F]FDG PET/CT in demonstrating dedifferentiation in castration-resistant prostate cancer

F. Kepenek et al.

Summary: This study aimed to determine the factors affecting increased glucose metabolism in patients with castration-resistant prostate cancer (CRPC) using [18F]FDG and [68Ga]Ga-PSMA PET/CT. The results showed that age and Gleason score were significant predictors of increased glucose metabolism. Combining [18F]FDG PET/CT with [68Ga]Ga-PSMA PET/CT is recommended in routine clinical practice to identify this patient subset and refer them to additional therapies.

MEDECINE NUCLEAIRE-IMAGERIE FONCTIONNELLE ET METABOLIQUE (2023)

Article Radiology, Nuclear Medicine & Medical Imaging

The Prognostic Value of Posttreatment 68Ga-PSMA-11 PET/ CT and 18F-FDG PET/CT in Metastatic Castration-Resistant Prostate Cancer Treated with 177Lu-PSMA-617 and NOX66 in a Phase I/II Trial (LuPIN)

Sarennya Pathmanandavel et al.

Summary: Lu-PSMA-617 therapy has shown high PSA response rates in men with metastatic castration-resistant prostate cancer, but early treatment resistance is common. This study aimed to determine the prognostic value of posttreatment quantitative PET for PSA progression-free survival and overall survival with 177Lu-PSMA-617 therapy.

JOURNAL OF NUCLEAR MEDICINE (2023)

Article Radiology, Nuclear Medicine & Medical Imaging

Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)

Clemens Kratochwil et al.

Summary: PSMA is expressed in most clinically significant prostate adenocarcinomas, and PSMA PET imaging can easily identify patients with target-positive disease. Early-phase studies have shown promising results with PSMA-targeted radiopharmaceutical therapy using different targeting molecules and radiolabels. [Lu-177]Lu-PSMA-617 in combination with standard-of-care has been demonstrated to be safe and effective in patients with metastatic castration-resistant prostate cancer. Ongoing phase 3 trials are evaluating the radiopharmaceuticals [Lu-177]Lu-PSMA-617 and [Lu-177]Lu-PSMA-I&T.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2023)

Review Radiology, Nuclear Medicine & Medical Imaging

Patients With Gray Zone PSA Levels: Application of Prostate MRI and MRS in the Diagnosis of Prostate Cancer

Xue Li et al.

Summary: This article presents a systematic review on the applications of MRI and MRS in detecting prostate cancer and clinically significant prostate cancer in men with PSA levels within the gray zone. The review shows that MRI and MRS have good performance in the prebiopsy diagnosis and guidance of prostate biopsy, leading to improved detection rates of prostate cancer and clinically significant prostate cancer.

JOURNAL OF MAGNETIC RESONANCE IMAGING (2023)

Review Endocrinology & Metabolism

Response to RL-225Ac in prostate cancer: Effect of prior treatment with RL-177Lu: A systematic review of the literature

Judith Stangl-Kremser et al.

Summary: This systematic literature review evaluated the impact of sequencing 177Lu-PSMA and 225Ac-PSMA targeted radionuclide therapy (TRT) in metastatic castration-resistant prostate cancer (mCRPC) patients. The results showed decreased efficacy of 225Ac-PSMA TRT in individuals previously treated with 177Lu-PSMA TRT. However, the current evidence is limited, and further randomized controlled trials are needed to establish the therapeutic efficacy and safety of 225Ac-PSMA TRT.

PROSTATE (2023)

Article Oncology

Comparison of Hormone-Sensitive Oligorecurrent Prostate Cancer Patients Based on Routine Use of Choline and/or PSMA PET/CT to Guide Metastasis-Directed Therapy

Raphael Metz et al.

Summary: Advances in metabolic imaging using 18F-choline (FCH) and 68Ga-PSMA PET/CT have improved the assessment of biochemical recurrence (BR) in prostate cancer and introduced the concept of oligometastatic disease. Several studies have shown that local treatment of oligometastases with external beam radiation therapy (EBRT) can improve biochemical recurrence-free survival (BR-FS). 68Ga-PSMA PET/CT has superior diagnostic performance compared to FCH for BR when the PSA value is low. A retrospective study showed that 68Ga-PSMA PET/CT-guided EBRT appeared to improve BR-FS compared to FCH PET/CT-guided EBRT, and PSA doubling time at recurrence was associated with treatment response.

CANCERS (2023)

Review Radiology, Nuclear Medicine & Medical Imaging

161Tb-PSMA Unleashed: a Promising New Player in the Theranostics of Prostate Cancer

Akram Al-Ibraheem et al.

Summary: Radiotheranostics with Lu-177-PSMA have become the new standard in certain settings for prostate cancer patients, and Tb-161 has emerged as a potential radionuclide with promising results. The first-in-human SPECT/CT imaging results from King Hussein Cancer Center demonstrate the tolerability and safety of Tb-161-PSMA radioligand therapy, contributing to the expanding field of radiotheranostics. Ongoing clinical trials will provide further insights, and the introduction of Tb-161-PSMA may help overcome challenges and build on the success of Lu-177-PSMA-based radiotheranostics.

NUCLEAR MEDICINE AND MOLECULAR IMAGING (2023)

Article Radiology, Nuclear Medicine & Medical Imaging

The Added Value of 18F-FDG PET/CT Compared with 68Ga-PSMA PET/CT in Patients with Castration-Resistant Prostate Cancer

Ruohua Chen et al.

Summary: The diagnostic efficiency of Ga-68-PSMA PET/CT and F-18-FDG PET/CT in CRPC patients was compared, and it was found that patients with high Gleason score and PSA may benefit from additional F-18-FDG PET/CT.

JOURNAL OF NUCLEAR MEDICINE (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Prostate-Specific Membrane Antigen Radioligand Therapy Using 177Lu-PSMA I&T and 177Lu-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer: Comparison of Safety, Biodistribution, and Dosimetry

Christiane Schuchardt et al.

Summary: The objective of this study was to assess the safety, kinetics, and dosimetry of Lu-177-labeled PSMA small molecules (Lu-177-PSMA I&T and Lu-177-PSMA-617) in patients with metastatic castration-resistant prostate cancer (mCRPC) undergoing PSMA radioligand therapy (PRLT). The study showed that both Lu-177-PSMA I&T and Lu-177-PSMA-617 demonstrated favorable safety and comparable absorbed tumor doses. However, there was variability in dosimetry parameters between patients, suggesting the need for personalized dosimetry in PRLT.

JOURNAL OF NUCLEAR MEDICINE (2022)

Review Pharmacology & Pharmacy

212Pb: Production Approaches and Targeted Therapy Applications

Konstantin V. Kokov et al.

Summary: Targeted alpha therapy has been proven to be highly effective in treating oncological diseases. Lead-212, with its convenient half-life and short-lived daughter alpha-emitter Bi-212, allows for the synthesis and purification of complex radiopharmaceuticals with minimal loss of radioactivity. This review discusses the various methods for isolating Pb-212 and the binding molecules used, as well as presents the results of preclinical studies and recent clinical trials.

PHARMACEUTICS (2022)

Editorial Material Radiology, Nuclear Medicine & Medical Imaging

Mismatched Lesions on 18F-FDG PET and 18F-Fluciclovine PET Images in a Patient With Metastatic Prostate Small Cell Carcinoma

Joshua Gu et al.

CLINICAL NUCLEAR MEDICINE (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

The added value of PSMA PET/MR radiomics for prostate cancer staging

Esteban Lucas Solari et al.

Summary: The study evaluated the performance of combined PET and mpMRI radiomics for predicting postsurgical Gleason scores in primary prostate cancer patients. The results showed that the PET + ADC double-modality model performed the best, significantly outperforming other models, and had better predictive ability for psGS compared to biopsy GS.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

An Improved 211At-Labeled Agent for PSMA-Targeted α-Therapy

Ronnie C. Mease et al.

Summary: This study synthesized a new radiotracer, At-211-3-Lu, for the treatment of PSMA-positive prostate cancer. The results showed that At-211-3-Lu had low toxicity, significant therapeutic effects, and no significant off-target toxicity.

JOURNAL OF NUCLEAR MEDICINE (2022)

Article Urology & Nephrology

Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part I: Introduction, Risk Assessment, Staging, and Risk-Based Management

James A. Eastham et al.

Summary: This article is part one of a three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline. It discusses risk assessment, staging, and risk-based management for patients diagnosed with clinically localized prostate cancer, providing guideline statements to aid clinicians.

JOURNAL OF UROLOGY (2022)

Article Urology & Nephrology

Predicting the Prognosis of Prostate Cancer Bone Metastasis Using the Bone Scan Index and Hot Spots Calculated Using VSBONECIRCLED LATIN CAPITAL LETTER R Bone Scan Index from Tc-99m-Hydroxymethylene Diphosphonate Bone Scintigraphy

Shigeaki Higashiyama et al.

Summary: This study aimed to demonstrate that the BSI calculated using VSBONECIRCLED LATIN CAPITAL LETTER R BSI and hot spots (HS) can be useful prognostic factors for patients with prostate cancer bone metastasis, similar to BONE NAVI.

UROLOGIA INTERNATIONALIS (2022)

Review Oncology

Current Opinion on the Use of Magnetic Resonance Imaging in Staging Prostate Cancer: A Narrative Review

Jamie Michael et al.

Summary: Accurate staging is crucial in prostate cancer for treatment planning and prognosis. MRI can assist in staging evaluation, but its sensitivity is limited. Guidelines vary in recommending the use of MRI for staging. For high-risk prostate cancer, most guidelines suggest using MRI for cross-sectional imaging. Despite MRI's good performance in assessing bone metastases, guidelines still recommend bone scintigraphy.

CANCER MANAGEMENT AND RESEARCH (2022)

Article Oncology

Comparison of [18F]PSMA-1007 with [68Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse

Manuela A. Hoffmann et al.

Summary: PSMA hybrid imaging can improve the diagnosis of recurrent prostate cancer. This study compared the diagnostic performance of [F-18]PSMA-1007 PET/CT and [Ga-68]Ga-PSMA-11 PET/CT by identifying PSA threshold levels. The results showed similar findings for both methods.

CANCERS (2022)

Article Oncology

[18F]Fluciclovine PET/CT Improves the Clinical Management of Early Recurrence Prostate Cancer Patients

Anna Giulia Nappi et al.

Summary: The choice of the most accurate PET tracer for evaluating prostate cancer patients in biochemical relapse should be guided by literature data and tailored to individual patient profiles. The semiquantitative analysis can aid in interpreting malignant from benign lesions. [F-18]Fluciclovine PET/CT shows reliability in early detection of recurrent prostate cancer and significant impact on therapeutic decision making.

CANCERS (2022)

Article Health Policy & Services

Exploring wait time variations in a prostate cancer patient pathway-A qualitative study

Anne Grete Valbekmo et al.

Summary: Norwegian health authorities emphasize healthcare equality and implement cancer patient pathways (CPPs) to avoid unwanted variation. This study identifies health system-related factors that cause differences in wait times for prostate cancer patients between a local hospital and a university hospital.

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Tc-99m-PSMA-SPECT/CT Is Superior to Tc-99m-MDP-SPECT/CT in the Staging of Prostatic Cancer with Osseous Metastases after External Beam Radiotherapy

Knut Liepe et al.

Summary: This case report describes a patient with advanced prostate cancer who had a false positive finding of thoracic vertebrae bone metastasis on a bone scan after external beam radiotherapy. An additional Tc-99m-prostate-specific membrane antigen scan showed a negative finding, but nonirradiated iliac bone metastasis was positive on both scans. The decrease in prostate-specific antigen level indicates a strong treatment effect, supporting the false positivity in the bone scan due to the flare phenomenon.

WORLD JOURNAL OF NUCLEAR MEDICINE (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Deep learning and radiomics framework for PSMA-RADS classification of prostate cancer on PSMA PET

Kevin H. Leung et al.

Summary: This study developed a deep learning and radiomics framework for lesion-level and patient-level classification on PSMA PET images of patients with PCa. The framework provided confidence and probability scores that may assist physicians in making more informed clinical decisions.

EJNMMI RESEARCH (2022)

Article Medicine, General & Internal

Segmented linear correlations between bone scan index and prostate cancer biomarkers, alkaline phosphatase, and prostate specific antigen in patients with a Gleason score ≥7

Ebrahim Tasmeera et al.

Summary: Technetium-99m methyl diphosphonate bone scintigraphy is a readily available method for detecting bone metastases in prostate cancer patients. The bone scan index (BSI) provides a more objective evaluation and allows for better comparison of images. This study found that BSI is better linearly correlated with alkaline phosphatase (ALP) than prostate specific antigen (PSA) in patients with a Gleason score >= 7.

MEDICINE (2022)

Article Oncology

Evaluation of a radiomics nomogram derived from Fluoride-18 PSMA-1007 PET/CT for risk stratification in newly diagnosed prostate cancer

Zhuonan Wang et al.

Summary: This study evaluated the performance of F-18-PSMA-1007-PET/CT radiomics for tumor malignancy and clinical risk stratification in primary prostate cancer. The results showed that F-18-PSMA-1007-PET/CT radiomics features can be used for preoperative individualized prediction of Gleason Score.

FRONTIERS IN ONCOLOGY (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Prediction of prostate cancer recurrence after radiation therapy using multiparametric magnetic resonance imaging and spectroscopy: assessment of prognostic factors on pretreatment imaging

Audrey Asuncion et al.

Summary: This study aims to assess the prognostic factors of biochemical relapse in localized prostate cancer patients treated by external radiotherapy or brachytherapy using pre-therapeutic multiparametric magnetic resonance imaging (mpMRI) combined with three-dimensional magnetic resonance spectroscopy (3D MRS).

QUANTITATIVE IMAGING IN MEDICINE AND SURGERY (2022)

Article Medicine, General & Internal

AlphaBet: Combination of Radium-223 and [177Lu]Lu-PSMA-I&T in men with metastatic castration-resistant prostate cancer (clinical trial protocol)

Louise Kostos et al.

Summary: The AlphaBet trial is a phase I/II study that aims to evaluate the combination of Ra-223 with [Lu-177]Lu-PSMA-I & T in patients with mCRPC. The study plans to recruit 36 patients and administer 7.4 GBq of [Lu-177]Lu-PSMA-I & T with escalating doses of Ra-223 concurrently every six weeks for up to six cycles. The primary objectives of the study are to determine the maximum tolerated dose of Ra-223 when combined with [Lu-177]Lu-PSMA-I & T and the 50% PSA response rate.

FRONTIERS IN MEDICINE (2022)

Article Medicine, General & Internal

Machine Learning and Clinical-Radiological Characteristics for the Classification of Prostate Cancer in PI-RADS 3 Lesions

Michela Gravina et al.

Summary: This study evaluates the application of machine learning methods in detecting prostate cancer in patients with PI-RADS score 3 lesions. The results show that machine learning algorithms can generate malignancy probabilities based on clinical and radiological information, providing assistance to physicians in diagnostic decisions.

DIAGNOSTICS (2022)

Review Pharmacology & Pharmacy

Advances in 177Lu-PSMA and 225Ac-PSMA Radionuclide Therapy for Metastatic Castration-Resistant Prostate Cancer

Sui Wai Ling et al.

Summary: Classic treatment options for mCRPC have limited survival benefits, leading to the emergence of beta and alpha radionuclide therapy (RNT) as novel treatment options. This review summarizes and discusses the clinical data of Lu-177-PSMA and Ac-225-PSMA RNT in patients with mCRPC, with promising results but still in development.

PHARMACEUTICS (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

Role of MRI, Ultrasound, and Computed Tomography in the Management of Prostate Cancer

Nancy Mohsen

PET CLINICS (2022)

Review Oncology

[68Ga]Ga-PSMA Versus [18F]PSMA Positron Emission Tomography/Computed Tomography in the Staging of Primary and Recurrent Prostate Cancer. A Systematic Review of the Literature

Laura Evangelista et al.

Summary: This systematic review analyzed the available literature on [Ga-68] and [F-18]-labeled prostate-specific membrane antigen and identified the advantages and disadvantages of different tracers for the management of patients with prostate cancer. The findings suggest that specific clinical indications may influence the choice of tracer preference.

EUROPEAN UROLOGY ONCOLOGY (2022)

Article Radiology, Nuclear Medicine & Medical Imaging

[18F]fluciclovine vs. [18F]fluorocholine Positron Emission Tomography/Computed Tomography: A Head-to-Head Comparison for Early Detection of Biochemical Recurrence in Prostate Cancer Patients

Cristina Ferrari et al.

Summary: There is still no consensus on the most accurate PET radiopharmaceutical to detect prostate cancer relapse early. This study compared the detection rate (DR) of [F-18]fluciclovine and [F-18]fluorocholine PET/CT in prostate cancer patients with early biochemical recurrence (BCR), and analyzed the impact of clinical and biochemical features. The results showed that [F-18]fluciclovine had a significantly higher DR compared to [F-18]fluorocholine, particularly in the detection of locoregional recurrence, and it was more effective in patients with low PSA values (PSA < 1 ng/mL).

TOMOGRAPHY (2022)

Review Urology & Nephrology

Role of multi-parametric magnetic resonance imaging fusion biopsy in active surveillance of prostate cancer: a systematic review

Elizabeth E. Ellis et al.

Summary: This study reviewed the role of mpMRI in the active surveillance of prostate cancer and found that FB and SB are complementary in detecting higher-grade disease during follow-up. Factors such as the number of lesions, lesion density, and MRI suspicion level can predict disease upgrading.

THERAPEUTIC ADVANCES IN UROLOGY (2022)

Review Radiology, Nuclear Medicine & Medical Imaging

Ultra-high-field MR in Prostate cancer: Feasibility and Potential

Carlijn J. A. Tenbergen et al.

Summary: Multiparametric MRI has become a reliable noninvasive imaging modality for identifying clinically significant prostate cancer. Ultra-high-field MRI holds the promise of imaging and spectroscopy of the prostate with unprecedented detail, but faces challenges due to the inhomogeneity of the radiofrequency field and high local specific absorption rates. This review discusses various coil designs and acquisition strategies to overcome these challenges and demonstrates the potential of ultra-high-field MRI in anatomical, functional, and metabolic imaging of the prostate.

MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE (2022)

Review Radiology, Nuclear Medicine & Medical Imaging

High resolution magic angle spinning MRS in prostate cancer

Matteo Sanchez-Dahl Gonzalez et al.

Summary: This review discusses the potential clinical benefits of incorporating high-resolution magic angle spinning magnetic resonance spectroscopy in the diagnosis, prognostication, and monitoring of prostate cancer.

MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE (2022)

Review Radiology, Nuclear Medicine & Medical Imaging

The role of MRI in prostate cancer: current and future directions

Maria Clara Fernandes et al.

Summary: MRI plays an increasingly important role in the management of prostate cancer, aiding in accurate detection, staging, risk stratification, guided biopsy, treatment planning, and assessment of local recurrence and metastatic disease. Recent advancements in radiomics and artificial intelligence are being tested to improve detection and provide potential prognostic markers.

MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE (2022)

Article Urology & Nephrology

Radium-223 in mCPRC patients: a large real-life Italian multicenter study

Viviana Frantellizzi et al.

Summary: This study provides a real-world perspective on the clinical performance of Radium-223 treatment in mCRPC patients, confirming its effectiveness in improving OS and quality of life while maintaining an excellent safety profile.

MINERVA UROLOGY AND NEPHROLOGY (2022)

Review Urology & Nephrology

EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer

Philip Cornford et al.

Summary: The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines provide evidence-based guidance on the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are continuously updated to reflect the latest research findings in the field.

EUROPEAN UROLOGY (2021)

Article Medicine, Research & Experimental

Combined bone scintigraphy and fluorocholine PET/computed tomography predicts response to radium-223 therapy in patients with prostate cancer

Michele Klain et al.

Summary: This study evaluated the combined assessment of bone scintigraphy and F-18-fluorocholine PET/CT in predicting response to (223)radium in men with prostate cancer. Patients with more bone lesions detected by F-18-fluorocholine PET/CT than bone scintigraphy had a poorer prognosis. The combined imaging approach could be useful in predicting outcomes after (223)radium therapy.

FUTURE SCIENCE OA (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

Radium-223 therapy for metastatic castration-resistant prostate cancer: survival benefit when used earlier in the treatment pathway

Peter Jarvis et al.

Summary: Early use of Ra-223 therapy in mCRPC patients with bone metastases significantly improves overall survival, with additional survival benefit noted in patients who complete all six cycles of therapy. These results support the utilization of Ra-223 earlier in the treatment pathway for mCRPC.

NUCLEAR MEDICINE COMMUNICATIONS (2021)

Article Oncology

The Role of Theranostics in Prostate Cancer

Elisabeth O'Dwyer et al.

Summary: Theranostics in men with metastatic castration-resistant prostate cancer (mCRPC) has focused on targeting bone and the tumor itself. Radium-223 (Ra-223) therapy has been proven to prolong survival, while other tumor-targeting therapies, such as Lu-177-labeled PSMA RLT, are showing promise in clinical trials. Additional studies are underway to investigate the efficacy of other targeted therapies like Ac-225 in mCRPC patients.

SEMINARS IN RADIATION ONCOLOGY (2021)

Review Radiology, Nuclear Medicine & Medical Imaging

Clinically Significant Prostate Cancer Detection With Biparametric MRI: A Systematic Review and Meta-Analysis

Renato Cuocolo et al.

Summary: The study confirms the feasibility of using biparametric MRI for detecting clinically significant prostate cancer, but there is heterogeneity in the quality of the included studies. A more robust validation and standardization of prostate biparametric MRI acquisition and reporting are needed.

AMERICAN JOURNAL OF ROENTGENOLOGY (2021)

Article Oncology

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung et al.

Summary: The global cancer burden in 2020 saw an estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths. Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer, while lung cancer remained the leading cause of cancer death. These trends are expected to rise in 2040, with transitioning countries experiencing a larger increase compared to transitioned countries due to demographic changes and risk factors associated with globalization and a growing economy. Efforts to improve cancer prevention measures and provision of cancer care in transitioning countries will be crucial for global cancer control.

CA-A CANCER JOURNAL FOR CLINICIANS (2021)

Article Oncology

Diagnostic Performance of 18F-DCFPyL-PET/CT in Men with Biochemically Recurrent Prostate Cancer: Results from the CONDOR Phase III, Multicenter Study

Michael J. Morris et al.

Summary: F-18-DCFPyL-PET/CT demonstrated good localization performance in patients with BCR, providing meaningful and actionable information that led to a change in management for 63.9% of patients.

CLINICAL CANCER RESEARCH (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

Diagnostic performance of 68Ga-PSMA-11 PET/MRI-guided biopsy in patients with suspected prostate cancer: a prospective single-center study

Daniela A. Ferraro et al.

Summary: This study assessed the performance of PSMA-PET/MRI in detecting and localizing clinically significant prostate cancer, demonstrating high accuracy and potential as a promising tool for selecting patients with suspicion of prostate cancer for biopsy.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2021)

Review Urology & Nephrology

EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

Nicolas Mottet et al.

Summary: The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on screening, diagnosis, and treatment of localized prostate cancer summarize the most recent recommendations for clinical practice, including risk-adapted strategies, medical imaging utilization, biopsy techniques, patient classification, and treatment options. Recommendations include consideration of moderate hypofractionation for intermediate-risk patients and a combination of local treatment with long-term hormonal therapy for cN1 PCa patients.

EUROPEAN UROLOGY (2021)

Article Urology & Nephrology

A Phase 2/3 Prospective Multicenter Study of the Diagnostic Accuracy of Prostate Specific Membrane Antigen PET/CT with 18F-DCFPyL in Prostate Cancer Patients (OSPREY)

Kenneth J. Pienta et al.

Summary: The study aimed to evaluate the diagnostic performance of F-18-DCFPyL positron emission tomography/computerized tomography in detecting metastatic sites of prostate cancer. The results showed high specificity and positive predictive value, but moderate sensitivity.

JOURNAL OF UROLOGY (2021)

Article Oncology

The prognostic power of 18F-FDG PET/CT extends to estimating systemic treatment response duration in metastatic castration-resistant prostate cancer (mCRPC) patients

Matteo Bauckneht et al.

Summary: The study aimed to investigate the prognostic value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in metastatic castration-resistant prostate cancer (mCRPC) regarding the estimation of systemic treatment response duration. Results showed that FDG-PET/CT could independently predict overall survival (OS) and treatment response duration in mCRPC patients, potentially influencing systemic treatment selection. Specifically, total lesion glycolysis (TLG) was found to impact the success rates of Androgen-Receptor Targeted Agents (ARTA) but not chemotherapy efficacy.

PROSTATE CANCER AND PROSTATIC DISEASES (2021)

Article Pharmacology & Pharmacy

Efficacy and Safety of [225Ac]Ac-PSMA-617 Augmented [177Lu]Lu-PSMA-617 Radioligand Therapy in Patients with Highly Advanced mCRPC with Poor Prognosis

Florian Rosar et al.

Summary: The study investigated the effectiveness and safety of [Ac-225]Ac-PSMA-617 augmented [Lu-177]Lu-PSMA-617 RLT in mCRPC patients with poor prognosis. The results showed promising biochemical and molecular imaging responses with a favorable side effects profile, indicating high clinical efficacy in this challenging patient cohort.

PHARMACEUTICS (2021)

Article Oncology

Combining External Beam Radiation and Radionuclide Therapies: Rationale, Radiobiology, Results and Roadblocks

E. M. Abbott et al.

Summary: The development of effective radionuclide therapeutics has driven rapid expansion in molecular radiotherapy research, with clinical trials helping to define optimal dosing protocols and identify patients who may benefit. Combining new MRT agents with other anticancer drugs, particularly DNA repair inhibitors and immunotherapeutics, is under investigation. Challenges in combining MRT with EBRT have been recognized, but advancements in imaging technology, dosimetry tools, and hardware will facilitate future use of this important treatment combination.

CLINICAL ONCOLOGY (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

[18F]-Fluciclovine PET/CT for preoperative nodal staging in high-risk primary prostate cancer: final results of a prospective trial

Lucia Zanoni et al.

Summary: The study aimed to evaluate the diagnostic performance of [F-18]-fluciclovine PET/CT for preoperative LN staging in high-risk primary PCa patients. The results showed that this method has some advantages in detecting lymph node metastases, but the sensitivity is still inadequate compared to PLND. Visual interpretation is promising but relies mainly on readers' experience rather than on unquestionable LN avidity.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2021)

Article Endocrinology & Metabolism

Combined 177Lu-PSMA-617 PRLT and abiraterone acetate versus 177Lu-PSMA-617 PRLT monotherapy in metastatic castration-resistant prostate cancer: An observational study comparing the response and durability

Sonam Suman et al.

Summary: The combination of Lu-177-PSMA-617 PRLT and AA therapy showed significant improvement in symptomatic response, PFS, and OS compared to Lu-177-PSMA-617 PRLT monotherapy in mCRPC patients in this study.

PROSTATE (2021)

Article Urology & Nephrology

Detection of Clinically Significant Prostate Cancer by Systematic TRUS-Biopsies in a Population-Based Setting Over a 20 Year Period

Sandra Miriam Kawa et al.

Summary: The study evaluated the performance of systematic TRUS-biopsies in detecting clinically significant prostate cancer in a population-based setting. Results showed that men with PSA > 20 ng/mL and cT2 tumors have a risk of over 75% for detecting csPCa in the first TRUS biopsy, while men with cT1 tumors and PSA < 20 ng/mL have a risk of at least 58% for non-malignant histology.

UROLOGY (2021)

Article Oncology

MRI-based radiomics models to assess prostate cancer, extracapsular extension and positive surgical margins

Dong He et al.

Summary: The MRI-based radiomics models showed good performance in discriminating benign and malignant prostate lesions and predicting ECE and PSM. Combining radiomics signatures and clinical factors enhanced the performance of the models, contributing to clinical diagnosis and treatment.

CANCER IMAGING (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

Competitive blocking of salivary gland [18F]DCFPyL uptake via localized, retrograde ductal injection of non-radioactive DCFPyL: a preclinical study

Jyoti Roy et al.

Summary: PSMA-targeted radionuclide therapy (TRT) is a promising treatment for prostate cancer, but dose-limiting xerostomia can be a barrier to its clinical adaptation. This study demonstrates a novel method to selectively reduce salivary gland uptake of systemically administered radionuclide by pre-infusion of non-radioactive standard of the radionuclide directly into the salivary gland, potentially mitigating xerostomia without compromising therapeutic efficacy.

EJNMMI RESEARCH (2021)

Article Urology & Nephrology

Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?

William John Yaxley et al.

Summary: Lu-PSMA RLT shows improved PSA response in men with only lymph node metastasis, especially in the chemotherapy naive cohort. These findings provide important evidence for planning future prospective randomized trials evaluating the role of Lu-PSMA RLT in the early treatment of node metastatic prostate cancer.

INVESTIGATIVE AND CLINICAL UROLOGY (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

Semiquantitative Parameters in PSMA-Targeted PET Imaging with [18F]DCFPyL: Intrapatient and Interpatient Variability of Normal Organ Uptake

Karine Sahakyan et al.

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