Translational Molecular Imaging of Prostate Cancer

Abstract

Prostate cancer is a heterogeneous disease, and its management is now evolving to become more personalized and to incorporate new targeted therapies. With these new changes comes a demand for molecular imaging techniques that can not only detect disease but also assess biology and treatment response. This review article summarizes current molecular imaging approaches in prostate cancer (e.g. 99mTc bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography) and highlights emerging clinical and preclinical imaging agents, with an emphasis on mechanism and clinical application. Emerging agents at various stages of clinical translation include radiolabeled analogs of lipid, amino acid, and nucleoside metabolism, as well as agents more specifically targeting prostate cancer biomarkers including androgen receptor, prostate-specific membrane antigen and others. We also highlight new techniques and targeted contrast agents for magnetic resonance imaging and spectroscopy. For all these imaging techniques, a growing and important unmet need is for well-designed prospective clinical trials to establish clear indications with clinical benefit in prostate cancer.

Correlation of PSMA-Targeted 18F-DCFPyL PET/CT Findings With Immunohistochemical and Genomic Data in a Patient With Metastatic Neuroendocrine Prostate Cancer

“…In an effort to improve upon the sensitivity and specify of these tests, many in the field have pursued the development molecularly-targeted imaging agents that utilize positron emission tomography (PET). 2,3 Currently, the most promising PET radiotracers for PCa imaging target prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein that is highly expressed on PCa epithelial cells. 4 A potential drawback of PSMA-targeted imaging of PCa, however, is that tumors with neuroendocrine differentiation do not reliably express PSMA, 5 thus providing a potential source of false negative tests.…”

89Zr-huJ591 immuno-PET imaging in patients with advanced metastatic prostate cancer

“…Current imaging challenges include that imaging has limited sensitivity in detecting early metastatic spread, distinguishing active cancer, and in monitoring posttreatment changes. While a number of imaging agents and radiopharmaceuticals including a variety of novel positron emission tomography (PET) tracers and small molecules have been used to image prostate cancer, the sensitivity and specificity to detect early metastases, viable disease, and monitor treatment is not optimal [1–4]. A number of small molecules that target gastrin peptide receptors or are directed towards prostate-specific membrane antigen (PSMA) have been investigated [5–9].…”

18F-DCFBC PET/CT for PSMA-Based Detection and Characterization of Primary Prostate Cancer

“…PET imaging has become an important functional imaging tool for diagnosis and staging in oncology, and several PET radiotracers have been developed and are being evaluated for detection and localization of primary prostate cancer (7,8). 18 F-FDG is generally limited for the detection of primary prostate cancer.…”