New aspects of molecular imaging in prostate cancer

• Published in: Methods (San Diego, Calif.) Calif.), 2017-11, Vol.130, p.36-41
• Main Authors: Ceci, Francesco, Castellucci, Paolo, Cerci, Juliano J., Fanti, Stefano
• Format: Article
• Language: English
• Subjects: 177Lu-PSMA; 18 F-FACBC: 68 Ga-RM2: prostate cancer; 68 Ga-PSMA; Animals; Antigens, Surface - blood; Biochemical recurrence; Glutamate Carboxypeptidase II - blood; Humans; Male; Metastases directed therapy; Molecular Imaging - methods; Molecular Imaging - trends; Positron Emission Tomography Computed Tomography - methods; Positron Emission Tomography Computed Tomography - trends; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnostic imaging; PSMA PET/CT; PSMA-I&T; Radiopharmaceuticals - administration & dosage; Radiopharmaceuticals - blood; Theranostics
• ISSN: 1046-2023; 1095-9130
• DOI: 10.1016/j.ymeth.2017.07.009

•Conventional radiological imaging proved sub-optimal accuracy for detecting PCa, particularly for detecting PCa metastases in the recurrence setting.•A new molecular probe targeting the prostate specific membrane antigen (PSMA) has been recently developed for PET imaging.•PSMA, the glutamate carboxypeptidase II, is a membrane bound metallo-peptidase over-expressed in PCa cells.•PSMA based imaging proved better accuracy compared to choline PET/CT and radiological imaging, especially in case of very low PSA levels during biochemical recurrence.•PSMA, as theranostics agent, allows both radio-labeling with diagnostic (e.g. 68Ga,18 F) or therapeutic nuclides (e.g. 177Lu).•Initial results show that PSMA-targeted radioligand therapy can potentially delay disease progression in metastatic castrate-resistant PCa.•Other PET radiotracers, like the bombesin-based radiotracers and antagonists of gastrin releasing-peptide receptor (GRP) or the anti1-amino-3-18 Ffluorocyclobutane-1-carboxylic acid (18F-FACBC), have been recently devolped. Nowadays several new imaging modalities are available for investigating prostate cancer (PCa) such as magnet resonance imaging (MRI) in the form of whole body MRI and pelvic multiparametric MRI and positron emission tomography (PET) using choline as radiotracers. Nevertheless, these modalities proved sub-optimal accuracy for detecting PCa metastases, particularly in the recurrence setting. A new molecular probe targeting the prostate specific membrane antigen (PSMA) has been recently developed for PET imaging. PSMA, the glutamate carboxypeptidase II, is a membrane bound metallo-peptidase over-expressed in PCa cells. It has been shown that PSMA based imaging offers higher tumor detection rate compared to choline PET/CT and radiological conventional imaging, especially at very low PSA levels during biochemical recurrence. In addition PSMA, as theranostics agent, allows both radiolabeling with diagnostic (e.g. 68Ga, 18F) or therapeutic nuclides (e.g. 177Lu, 225Ac). Initial results show that PSMA-targeted radioligand therapy can potentially delay disease progression in metastatic castrate-resistant PCa. Despite still investigational, the bombesin-based radiotracers and antagonist of gastrin releasing-peptide receptor (GRP) (RM2) and anti1-amino-3-18Ffluorocyclobutane-1-carboxylic acid (18F-FACBC) are emerging as possible alternatives for investigating PCa. Considering the wide diffusion of PCa in the Europe and the United States, the prese