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World Journal of Urology

, Volume 37, Issue 3, pp 457–467 | Cite as

Current and potential future role of PSMA-PET in patients with castration-resistant prostate cancer

  • Christian Daniel FankhauserEmail author
  • Cédric Poyet
  • Stephanie G. C. Kroeze
  • Benedikt Kranzbühler
  • Helena I. Garcia Schüler
  • Matthias Guckenberger
  • Philipp A. Kaufmann
  • Thomas Hermanns
  • Irene A. Burger
Invited Review
  • 422 Downloads

Abstract

Purpose

To review the current literature and discuss potential future roles of the novel positron emission tomography (PET) tracers targeting the prostate-specific membrane antigen (PSMA) in patients with castration-resistant prostate cancer (CRPC).

Methods

A literature search on February 19th 2018 was conducted using the Medline database and www.clinicaltrials.gov. Additionally, illustrative cases of CRPC patients from our own institution who were restaged and treated based on PSMA-PET scan results are provided.

Results

11 Studies met the inclusion criteria. PSMA-PET detected more metastatic lesions compared to conventional bone scan. Several patients were up-staged from non-metastatic CRPC (nmCRPC) to metastatic CRPC (mCRPC). Currently, no clear consensus exists regarding treatment response assessment in PSMA-PET scans for mCRPC patients undergoing treatment. Also, the role of PSMA-PET as a gatekeeper for systemic therapy or radioligands is currently undefined. PSMA-guided metastasis-directed radiotherapy may not only alleviate local symptoms but has the potential to defer systemic treatment in patients with oligoprogressive CRPC.

Conclusion

Compared to bone scan, PSMA-PET is more sensitive and specific to detect metastases but the therapeutic consequences of PSMA-PET results in the setting of CRPC remain unclear. Until future studies define the role of PSMA-PET in patients with CRPC, the current standard for imaging remains bone scan and computerized tomography.

Keywords

Prostatic neoplasms CRPC Positron emission tomography computed tomography Review (68)Ga-PSMA 

Notes

Author contributions

CDF: Protocol/project development, Other (Literature research), Manuscript writing/editing. CP: Manuscript writing/editing. BK: Manuscript writing/editing. SGCK: Manuscript writing/editing. HG: Manuscript writing/editing. PAK: Manuscript writing/editing. MG: Manuscript writing/editing. TH: Manuscript writing/editing. BIA: Protocol/project development, Manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Patients mentioned as examples provided written informed consent.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Christian Daniel Fankhauser
    • 1
    Email author
  • Cédric Poyet
    • 1
  • Stephanie G. C. Kroeze
    • 2
  • Benedikt Kranzbühler
    • 1
  • Helena I. Garcia Schüler
    • 2
  • Matthias Guckenberger
    • 2
  • Philipp A. Kaufmann
    • 3
  • Thomas Hermanns
    • 1
  • Irene A. Burger
    • 3
  1. 1.Department of UrologyUniversity of ZurichZurichSwitzerland
  2. 2.Department of Radiation OncologyUniversity of ZurichZurichSwitzerland
  3. 3.Department of Nuclear MedicineUniversity of ZurichZurichSwitzerland

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