Review of commonly used prostate specific PET tracers used in prostate cancer imaging in current clinical practice

18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) underperforms in detecting prostate cancer (PCa) due to inherent characteristics of primary and metastatic tumors, including relatively low rate of glucose utilization. Consequently, alternate PCa PET imaging agents targeting other aspect...

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Bibliographic Details
Published in:Clinical imaging 2021-11, Vol.79, p.278-288
Main Authors: Niaz, Muhammad Junaid, Sun, Michael, Skafida, Myrto, Niaz, Muhammad Obaid, Ivanidze, Jana, Osborne, Joseph R., O'Dwyer, Elisabeth
Format: Article
Language:English
Subjects:
Androgens
Antigens
Biopsy
Bone marrow
Choline
Clinical medicine
FDA approval
Fluorine isotopes
Glucose metabolism
Lymphatic system
Magnetic resonance imaging
Medical imaging
Metastases
Metastasis
Molecular imaging
Patients
Positron emission
Positron emission tomography
Prostate cancer
Prostate specific membrane antigen
Radiation
Radiation therapy
Scintigraphy
Tomography
Tracers
Tumors
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Summary:18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) underperforms in detecting prostate cancer (PCa) due to inherent characteristics of primary and metastatic tumors, including relatively low rate of glucose utilization. Consequently, alternate PCa PET imaging agents targeting other aspects of PCa cell biology have been developed for clinical practice. The most common dedicated PET imaging tracers include 68Ga/18F prostate-specific membrane antigen (PSMA), 11C-Choline, and 18F-fluciclovine (Axumin™). This review will describe how these agents target specific inherent characteristics of PCa and explore the current literature for these agents for both primary and recurrent PCa, comparing the advantages and limitations of each tracer. Both 11C-Choline and 18F-Fluciclovine PET have been shown to detect nodal and osseous disease at higher rates compared to FDG-PET but offer no additional benefit in detecting prostate disease, especially in primary staging. As a result, PSMA PET, specifically 68Ga-PSMA-11, has emerged as a key imaging option for both primary and recurrent cancer. PSMA PET may be more sensitive than MRI at the local level and more sensitive than 11C-Choline and 18F-Fluciclovine PET for distant disease. Furthermore, compared to 11C-Choline and 18F-Fluciclovine PET, 68Ga-PSMA-11 PET has higher detection rates at low PSA levels (
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2021.06.006