Abstract
Metastatic castration resistant prostate cancer (mCRPC) is incurable. The expression of the transmembrane protein prostate specific membrane antigen (PSMA) is markedly increased in most mCRPC lesions. PSMA has been recognized as a viable biological target for imaging and radionuclide therapy (theranostics) in mCRPC. The positron emission tomography (PET) agents 68Ga-PSMA-11 and 18F-DCFPyL have recently been approved for imaging evaluation of patients with suspected metastasis who are candidates for initial definitive therapy and patients with suspected recurrence based on elevated serum prostate-specific antigen (PSA) level. Radioligand therapy (RLT) with 177Lu-PSMA-617 is anticipated to be approved relatively soon based on the favorable results of the VISION trial. It has been recognized that PET imaging of PSMA expression and glucose metabolism (with 18F-fluorodeoxyglucose) provides a more comprehensive assessment of the tumor burden and heterogeneity. However, there are many unresolved issues that surround whether or not imaging with 18F-fluoroodexyglucose PET is advantageous in the clinical setting of PSMA RLT in mCRPR.
- Copyright © 2021 by the Society of Nuclear Medicine and Molecular Imaging, Inc.