Clinical Applications of PSMA PET Examination in Patients with Prostate Cancer

Abstract

With the progressive aging of the population in industrially developed countries, as well as advances in diagnostic and biopsy techniques and improvements in patient awareness, the incidence of prostate cancer (PCa) is continuously increasing worldwide. Therefore, PCa is currently considered as the second leading cause of tumor-related death. Early detection of the tumor and its metastasis is essential, as the rate of disease recurrence is high and occurs in 27% to 53% of all patients who underwent curative therapy with radical prostatectomy or local radiotherapy. In this regard, the prostate specific membrane antigens, abbreviated as PSMAs, are type II membrane proteins that are highly expressed on the surface of malignant prostate tissue in PCa, particularly in aggressive, androgen-deprived, metastatic, and hormone-refractory PCa, and they are inversely associated with the androgen level. Up to 95% of adenocarcinomas of the prostate express PSMA receptors on their surface. Today, radionuclides that bind to these PSMA peptides are widely accepted for diagnostic and therapeutic purposes to specifically image and target prostate tumor cells at the molecular level, a process referred to as targeted theranostics. Numerous studies have demonstrated that the integration of these peptides into diagnostic and therapeutic procedures plays a critical role in the primary staging and treatment decisions of especially high-risk PCa, expands therapeutic options for patients with advanced stage of prostate tumor, and prolongs patients’ survival rate. In this review article, we intend to briefly spotlight the latest clinical utilization of the PSMA-targeted radioligand PET imaging modality in patients with different stages of PCa. Furthermore, limitations and pitfalls of this diagnostic technique are presented.

Hotspots and frontiers in PSMA research for prostate cancer: a bibliometric and visualization analysis over the past 20 years

“…The Prostate-specific membrane antigen (PSMA) expression increases by 100 to 1000-fold in about 95% of PCa cells, making it an efficient target for imaging and treatment, particularly in aggressive types characterized by high Gleason scores (GS), as well as in cases of androgen-deprived, metastatic, and hormone-refractory PCa [ 4 , 5 ]. The PSMA-ligand complex exhibits a distinctive behavior, being internalized through clathrin-coated pits and accumulating within endosomes [ 6 ].…”

Dosimetric comparison between stereotactic body radiotherapy and carbon-ion radiation therapy for prostate cancer

“…Prostate cancer, a common malignant tumor in the male urogenital system that occurs in the prostatic epithelium, is a major public health issue ( 1 , 2 ). With advances in the development of prostate-specific antigen (PSA) screening, prostate-specific membrane antigen (PSMA), genetic testing, molecular imaging, and other technologies ( 3 - 6 ), the incidence rate of prostate cancer is increasing year by year, as shown in Table 1 ( 7 , 8 ).…”

Synthesis of a Bifunctional Cross‐Bridged Chelating Agent, Peptide Conjugation, and Comparison of 68Ga Labeling and Complex Stability Characteristics with Established Chelators

“…68 Ga‐radiolabeled peptides have emerged as important and powerful tools for the specific and sensitive visualization of malignancies of various origin by Positron Emission Tomography (PET) in routine clinical practice. [ 1 , 2 , 3 ]…”

“…Introduction 68 Ga-radiolabeled peptides have emerged as important and powerful tools for the specific and sensitive visualization of malignancies of various origin by Positron Emission Tomography (PET) in routine clinical practice. [1][2][3] For labeling purposes, the [ 68 Ga]Ga 3 + ion is introduced into the peptide carriers by means of complexation by a peptideconjugated chelating agent. Here, several different chelators can be employed, but the most commonly used chelating agent for 68 Ga-introduction into peptides is DOTA (1,4,7,10tetraazacyclododecane-1,4,7,10-tetraacetic acid).…”