Update on advances in molecular PET in urological oncology

Abstract

Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) has emerged as a powerful tool for the combined metabolic and anatomic evaluation of many cancers. In urological oncology, however, the use of 18F-FDG has been limited by a generally low tumor uptake, and physiological excretion of FDG through the urinary system. 18F-FDG PET/CT is useful when applied to specific indications in selected patients with urological malignancy. New radiotracers and positron emission tomography/magnetic resonance imaging (PET/MRI) are expected to further improve the performance of PET in uro-oncology.

Clinical Translation of a Dual Integrin αvβ3– and Gastrin-Releasing Peptide Receptor–Targeting PET Radiotracer, 68Ga-BBN-RGD

“…Besides BBN-based imaging probes, various PET tracers have been used for the detection of prostate cancer such as 18 F-FDG, 11 C-choline or 18 F-fluorcholine, 11 C-acetate, 18 F-FACBC, and prostate-specific membrane antigen targeting agents (35). Each of these tracers has advantages and limitations because of the heterogeneity of the disease.…”

The Role of Imaging in Testicular Cancer Diagnosis, Staging and Follow-up

“…'nın (37) seminom tanılı olgularda kemoterapi sonrası takipte PET-BT etkinliğinin değerlendirildiği metaanaliz verilerine göre, PET-BT duyarlılığı %78, özgüllüğü %86, pozitif öngörü değeri %58, negatif öngörü değeri %94 ve kesinliği %84 olarak bulunmuştur. NSGHT tanılı olgularda yapılan bir başka çalışmada duyarlılık %70, özgüllük %48, kesinlik %56 olarak bulunmuş olup pozitif öngörü değerinin BT, serum belirteçleri ya da PET'den farklı olmadığı ve negatif öngörü değerinin %83 olduğu gösterilmiş ve ek klinik yararının olmadığı söylenmiştir (38,39). Lenfotropik nanopartikül kontrastlı MRG ile patolojik lenf nodlarının daha iyi gösterildiğine dair çalışmalar mevcut olmakla birlikte bu konuda yapılacak prospektif çalışmalara ihtiyaç duyulmaktadır (19,40).…”

11C-Choline-Avid but 18F-FDG-Nonavid Prostate Cancer with Lymph Node Metastases on Positron Emission Tomography

“…Although 18 F-FDG, an analog of glucose that can visualize metabolic activity, is the most widely used radiotracer for imaging of various malignancies, its application to prostate cancer is limited because of its low sensitivity and specificity [1, 2]. Moreover, urinary excretion of 18 F-FDG in the urinary bladder may interfere with evaluation of prostate lesions.…”

“…Moreover, urinary excretion of 18 F-FDG in the urinary bladder may interfere with evaluation of prostate lesions. Many new tracers have been introduced to overcome these limitations: 18 F- or 11 C-choline, 18 F- or 11 C-acetate, 16β- 18 F-fluoro-5α-dihydrotestosterone, anti-3- 18 F-fluorocyclobutane-1-carboxylic acid, and prostate-specific membrane antigen are currently under investigation [2]. …”

“…In Western countries 11 C- and 18 F-choline PET/CT has been used successfully for restaging of prostate cancer in patients with biochemical disease recurrence after definitive therapy [1, 2, 3]. 11 C-choline uptake may occur via a choline-specific transporter protein that is overexpressed in the membranes of prostate cancer cells [4].…”