Abstract
Imaging prostate cancer and metastases either by morphologic radiological approach or nuclear medicine methods has not fulfilled the expectations of the clinicians until several years. PSMA—prostate-specific membrane antigen—which can be labeled with positron-emitting isotopes mostly 68Ga—changed this setting substantially. Prostate cancer is the most common tumor entity in men worldwide and the third leading cause of cancer-related death in men in Europe and the USA. Biochemical relapse is a frequent event after primary therapy. A large body of evidence is available for restaging of prostate cancer patients with biochemical recurrence. 68Ga-PSMA PET/CT demonstrates high detection rates in patients with biochemical recurrence of prostate cancer after primary radiation therapy as well as after radical prostatectomy. 68Ga-PSMA PET has also been used for radiotherapy planning. Compared to conventional CT, PSMA PET/CT had a remarkable impact on radiotherapeutic approach especially in postoperative patients. PSMA is an ideal structure for both imaging and targeted therapy for prostate cancer, therefore enabling a theranostic approach.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- 18F-DCFBC:
-
(N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-F-fluorobenzyl-l-cysteine)
- 18F-DCFPyL:
-
2-(3-{1-carboxy-5-[(6-[(18)F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid
- 18F-FDG:
-
18F-Fluorodeoxyglucose
- 18F-FET:
-
18F-Fluoroethylthirosine
- 68Ga-PSMA:
-
68Ga-prostate-specific membrane antigen
- DOTAtaGA:
-
(1,4,7,10-tetraazacyclododecane-1-(1-carboxy-3-carbo-tertbutoxypropyl)-4,10 (carbotertbutoxymethyl)-7-acetamide)
- PET/CT:
-
Positron emission tomography/ computed tomography
- PET/MRI:
-
Positron emission tomography/magnetic resonance imaging
- PSA:
-
Prostate-specific antigen
References
Nanabala R, Anees MK, Sasikumar A, et al. Preparation of [(68)Ga]PSMA-11 for PET-CT imaging using a manual synthesis module and organic matrix based (68)Ge/(68)Ga generator. Nucl Med Biol. 2016;43:463–9.
Giovacchini G, Giovannini E, Riondato M, et al. PET/CT with 68Ga-PSMA in prostate cancer: radiopharmaceutical background and clinical implications. Curr Radiopharm. 2018;11:4–13.
Afshar-Oromieh A, Babich JW, Kratochwil, et al. The rise of PSMA ligands for diagnosis and therapy of prostate cancer. J Nucl Med. 2016;57:79S–89S.
Sheikhbahaei S, Afshar-Oromieh A, Eiber M, et al. Pearls and pitfalls in clinical interpretation of prostate-specific membrane antigen (PSMA)-targeted PET imaging. Eur J Nucl Med Mol Imaging. 2017;44:2117–36.
Lenzo NP, Meyrick D, Turner JH, et al. Review of gallium-68 PSMA PET/CT imaging in the management of prostate cancer. Diagnostics (Basel). 2018;11, 8
Eiber M, Maurer T, Souvatzoglou M, et al. Evaluation of hybrid 68Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. 2015;56:668–74.
Jadvar H. PSMA PET in prostate cancer. J Nucl Med. 2015;56:1131–2.
Salas Fragomeni RA, Amir T, Sheikhbahaei S, et al. Imaging of nonprostate cancers using PSMA-targeted radiotracers: rationale, current state of the field, and a call to arms. J Nucl Med. 2018;59:871–7.
Ceci F, Uprimny C, Nilica B, et al. 68Ga-PSMA PET/CT for restaging recurrent prostate cancer: which factors are associated with PET/CT detection rate? Eur J Nucl Med Mol Imaging. 2015;42:1284–94.
Freedland SJ, Presti JC Jr, Amling CL, et al. Time trends in biochemical recurrence after radical prostatectomy: results of the SEARCH database. Urology. 2003;61:736–41.
Rayn KN, Elnabawi YA, Sheth N. Clinical implications of PET/CT in prostate cancer management. Transl Androl Urol. 2018;7:844–54.
Grubmüller B, Baltzer P, Hartenbach S, et al. PSMA ligand PET/MRI for primary prostate cancer: staging performance and clinical impact. Clin Cancer Res. 2018;24:6300–7.
Afshar-Oromieh A, Avtzi E, Giesel FL, et al. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:197–209.
Schwarzenboeck SM, Rauscher I, Bluemel C, et al. PSMA ligands for PET imaging of prostate cancer. J Nucl Med. 2017;58:1545–52.
Perera M, Papa N, Roberts M, et al. Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer-updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: a systematic review and meta-analysis. Eur Urol. 2019;. [Epub ahead of print]
Müller J, Ferraro DA, Muehlematter UJ, et al. Clinical impact of 68Ga-PSMA-11 PET on patient management and outcome, including all patients referred for an increase in PSA level during the first year after its clinical introduction. Eur J Nucl Med Mol Imaging. 2019;6:889–900.
Einspieler I, Rauscher I, Düwel C, et al. Detection efficacy of hybrid 68Ga-PSMA ligand PET/CT in prostate cancer patients with biochemical recurrence after primary radiation therapy defined by phoenix criteria. J Nucl Med. 2017;58:1081–7.
Schmidt-Hegemann NS, Fendler WP, Ilhan H, et al. Outcome after PSMA PET/CT based radiotherapy in patients with biochemical persistence or recurrence after radical prostatectomy. Radiat Oncol. 2018;13:37.
Calais J, Czernin J, Cao M, et al. 68Ga-PSMA-11 PET/CT mapping of prostate cancer biochemical recurrence after radical prostatectomy in 270 patients with a PSA level of less than 1.0 ng/mL: impact on salvage radiotherapy planning. J Nucl Med. 2018;59:230–7.
Calais J, Czernin J, Fendler WP, et al. Randomized prospective phase III trial of 68Ga-PSMA-11 PET/CT molecular imaging for prostate cancer salvage radiotherapy planning [PSMA-SRT]. BMC Cancer. 2019;19:97.
Heinzel A, Boghos D, Mottaghy FM, et al. 68Ga-PSMA PET/CT for monitoring response to 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging. 2019;46:1054–62.
Weineisen M, Schottelius M, Simecek J, et al. 68Ga- and 177Lu-labeled PSMA I&T: optimization of a PSMA-targeted theranostic concept and first proof-of-concept human studies. J Nucl Med. 2015;56:1169–76.
Sathekge M, Bruchertseifer F, Knoesen O, et al. 225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study. Eur J Nucl Med Mol Imaging. 2019;46:129–38.
Kesavan M, Turner JH, Meyrick D, et al. Salvage radiopeptide therapy of advanced castrate-resistant prostate cancer with lutetium-177-labeled prostate-specific membrane antigen: efficacy and safety in routine practice. Cancer Biother Radiopharm. 2018;33:274–81.
Afshar-Oromieh A, Zechmann CM, Malcher A, et al. Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2014;41:11–20.
Lütje S, Heskamp S, Cornelissen AS, et al. PSMA ligands for radionuclide imaging and therapy of prostate cancer: clinical status. Theranostics. 2015;5:1388–401.
Parent EE, Schuster DM. Update on 18F-fluciclovine PET for prostate cancer imaging. J Nucl Med. 2018;59:733–9.
England JR, Paluch J, Ballas LK, et al. 18F-fluciclovine PET/CT detection of recurrent prostate carcinoma in patients with serum PSA ≤ 1 ng/mL after definitive primary treatment. Clin Nucl Med. 2019;44:e128–32.
Andriole GL, Kostakoglu L, Chau A, et al. The impact of positron emission tomography with 18F-fluciclovine on the treatment of biochemical recurrence of prostate cancer: results from the LOCATE trial. J Urol. 2019;201:322–31.
Koerber SA, Will L, Kratochwil C, et al. 68Ga-PSMA-11 PET/CT in primary and recurrent prostate carcinoma: implications for radiotherapeutic management in 121 patients. J Nucl Med. 2019;60(2):234–40.
Rauscher I, Maurer T, Fendler WP, et al. (68)Ga-PSMA ligand PET/CT in patients with prostate cancer: how we review and report. Cancer Imaging. 2016;16:14.
Afshar-Oromieh A, Sattler LP, Mier W, et al. The clinical impact of additional late PET/CT imaging with 68Ga-PSMA-11 (HBED-CC) in the diagnosis of prostate cancer. J Nucl Med. 2017;58:750–5.
Krohn T, Verburg FA, Pufe T, et al. [(68)Ga]PSMA-HBED uptake mimicking lymph node metastasis in coeliac ganglia: an important pitfall in clinical practice. Eur J Nucl Med Mol Imaging. 2015;42:210–4.
Strele-Trieb P, Dunzinger A, Sonnberger M, et al. Uptake of 68Ga-prostate-specific membrane antigen pet in adrenal gland: a potential pitfall. Clin Nucl Med. 2018;43:50–1.
Calabria F, Gangemi V, Gullà D, et al. 64Cu-PSMA uptake in meningioma: a potential pitfall of a promising radiotracer. Rev Esp Med Nucl Imagen Mol. 2017;36:335–6.
Kesler M, Levine C, Hershkovitz D, et al. 68Ga-PSMA is a novel PET-CT tracer for imaging of hepatocellular carcinoma: a prospective pilot study. J Nucl Med. 2018;. [Epub ahead of print]
Backhaus P, Noto B, Avramovic N, et al. Targeting PSMA by radioligands in non-prostate disease-current status and future perspectives. Eur J Nucl Med Mol Imaging. 2018;45:860–77.
Nomura N, Pastorino S, Jiang P, et al. Prostate specific membrane antigen (PSMA) expression in primary gliomas and breast cancer brain metastases. Cancer Cell Int. 2014;14:26.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Pichler, R., Wolfsgruber, J., Calabria, F., Schillaci, O., Dunzinger, A. (2020). 68Ga-PSMA. In: Calabria, F., Schillaci, O. (eds) Radiopharmaceuticals. Springer, Cham. https://doi.org/10.1007/978-3-030-27779-6_12
Download citation
DOI: https://doi.org/10.1007/978-3-030-27779-6_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-27778-9
Online ISBN: 978-3-030-27779-6
eBook Packages: MedicineMedicine (R0)