Nuclear Medicine Imaging of Prostate Cancer Nuklearmedizinische Diagnostik des Prostatakarzinoms

Correspondence Dr. Vera Schreiter Radiology, Charité Universitätsmedizin Berlin Augustenburger Platz 1 13353 Berlin Germany Tel.: ++ 49/30/4 506571 65 Fax: ++ 49/30/5279 94 [email protected] Introduction ▼ The use of gallium-68 (Ga-68)-labeled prostate-specific membrane antigen (PSMA) ligands for the diagnosis of prostate cancer is a promising innovation for the metabolic imaging of prostate cancer according to initial study results and empirical data from the clinical routine [1–10]. The purpose of the present study is to evaluate the current diagnostic value of positron emission tomography/computed tomography (PET/CT) using the new Ga-68-labeled PSMA tracer compared to previously used choline tracers. The comparison focuses on the most common tracer in German-speaking regions, i. e., Ga68-labeled PSMA tracer with the chelator N,N′-bis[2-hydroxy-5-(carboxyethyl)benzyl] ethylenediamine-N,N′-diacetic acid (HBEDCC), referred to in the following as Ga-68PSMA. Its diagnostic accuracy for detecting PCa is compared to that of labeled choline derivatives[F-18 choline (F-18 fluoroethylcholine, F-18 fluoromethylcholine) and C-11 choline]. Tracers used less frequently for the diagnosis of prostate cancer, such as F-18 or C-11-labeled acetate derivatives (F-18 fluoroacetate and C-11 acetate), receptor ligands, or the standard tracer in diagnostic tumor imaging F-18 fluorodeoxyglucose are not discussed in this comparison because of their lack of relevance for the diagnosis of PCa. Abstract ▼ The new tracer Gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) yields new promising options for the PET/CT diagnosis of prostate cancer (PCa) and its metastases. To overcome limitations of hybrid imaging, known from the use of choline derivatives, seems to be possible with the use of Ga-68 PSMA for PCa. The benefits of hybrid imaging with Ga-68 PSMA for PCa compared to choline derivatives shall be discussed in this article based on an overview of the current literature. Key Points: ▶ Ga-68 PSMA PET/CT can achieve higher detection rates of PCa lesions than PET/CT performed with choline derivatives ▶ The new tracer Ga-68 PSMA has the advantage of high specificity, independence of PSA-level and low nonspecific tracer uptake in surrounding tissue ▶ The new tracer Ga-68 PSMA seems very suitable for MR-PET diagnostic Citation Format: ▶ Schreiter V, Reimann C, Geisel D et al. Nuclear Medicine Imaging of Prostate Cancer. Fortschr Röntgenstr 2016; 188: 1037–1044