Will 68Ga PSMA-radioligands be the only choice for nuclear medicine in prostate cancer in the near future? A clinical update.

Nuclear Medicine Unit, Department of Clinical and Experimental Internistic «F. Magrassi - A. Lanzara» - University of Campania Luigi Vanvitelli, Napoli, Italia. Electronic address: vincenzo.cuccurullo@unicampania.it. Nuclear Medicine Unit, Department of Clinical and Experimental Internistic «F. Magrassi - A. Lanzara» - University of Campania Luigi Vanvitelli, Napoli, Italia. Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto (IOV-IRCCS), Padova, Italia. Department of Nuclear Medicine, S. Andrea Hospital, La Spezia, Italia. Interuniversity Research Centre on Sustainable Development (CIRPS), Roma-Napoli, Italia.

Revista espanola de medicina nuclear e imagen molecular. 2018;(2):103-109
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Abstract

Prostate Cancer (PCa) represents the most common malignant tumor in men but according to the European Association of Urology (EAU) guidelines, a mass screening for PCa diagnosis should not be performed due to over-diagnosis and over-treatment related problems. An early clinical diagnosis is possible, mainly based on digital rectal examination and Prostatic Specific Agent (PSA) testing. However, the only mandatory test to define the presence of PCa is ultrasound guided-biopsy, obtained on multiple samples, which has also a high prognostic value. In this context, diagnostic imaging plays an important role as confirmed by EAU that in a 2016 update of their guidelines on PCa stated the importance of Positron Emission Tomography (PET) with 11C- or 18F-choline combined with computed tomography (CT) to identify local relapse, lymph node involvement and metastatic spread at all stages. Consequently, in 2017, the European Association of Nuclear Medicine (EANM) together with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published new guidelines for 68Ga-Prostate Specific Membrane Antigen (PSMA) PET/CT to help physicians in the recommendation, execution and interpretation of PET/CT scans in patients with PCa. Thus, the aim of this 'evidence paper' is to define the current diagnostic algorithm in PCa in order to increase the general level of confidence in approaching such a crucial topic.

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Publication Type : Review

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