Molecular imaging of prostate cancer: translating molecular biology approaches into the clinical realm
The epidemiology of prostate cancer has dramatically changed since the introduction of prostate-specific antigen (PSA) screening in the 1980’s. Most prostate cancers today are detected at early stages of the disease and are considered ‘indolent’; however, some patients’ prostate cancers demonstrate a more aggressive behaviour which leads to rapid progression and death. Increasing understanding of the biology underlying the heterogeneity that characterises this disease has led to a continuously evolving role of imaging in the management of prostate cancer. Functional and metabolic imaging techniques are gaining importance as the impact on the therapeutic paradigm has shifted from structural tumour detection alone to distinguishing patients with indolent tumours that can be managed conservatively (e.g., by active surveillance) from patients with more aggressive tumours that may require definitive treatment with surgery or radiation. In this review, we discuss advanced imaging techniques that allow direct visualisation of molecular interactions relevant to prostate cancer and their potential for translation to the clinical setting in the near future. The potential use of imaging to follow molecular events during drug therapy as well as the use of imaging agents for therapeutic purposes will also be discussed.
• Advanced imaging techniques allow direct visualisation of molecular interactions in prostate cancer.
• MRI/PET, optical and Cerenkov imaging facilitate the translation of molecular biology.
• Multiple compounds targeting PSMA expression are currently undergoing clinical translation.
• Other targets (e.g., PSA, prostate-stem cell antigen, GRPR) are in development.
KeywordsProstate cancer Molecular imaging MRI/PET Optical imaging Cerenkov imaging
Magnetic resonance imaging
Single-photon emission computed tomography
Prostate-specific membrane antigen
Prostate stem cell antigen
Gastrin-releasing peptide receptor
Benign prostatic hyperplasia
The scientific guarantor of this publication is Hedvig Hricak. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because this was a review article.
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