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    Ga-68-prostate-specific membrane antigen-positron emission tomography/computed tomography in advanced prostate cancer: Current state and future trends

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    Author
    Udovicich, C; Perera, M; Hofman, MS; Siva, S; Del Rio, A; Murphy, DG; Lawrentschuk, N
    Date
    2017-12-01
    Source Title
    Prostate International
    Publisher
    ELSEVIER INC
    University of Melbourne Author/s
    Hofman, Michael; Siva, Shankar; Murphy, Declan; Lawrentschuk, Nathan; Perera, Marlon Lakmal
    Affiliation
    Surgery (Austin & Northern Health)
    Sir Peter MacCallum Department of Oncology
    Surgery (St Vincent's)
    Metadata
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    Document Type
    Journal Article
    Citations
    Udovicich, C., Perera, M., Hofman, M. S., Siva, S., Del Rio, A., Murphy, D. G. & Lawrentschuk, N. (2017). Ga-68-prostate-specific membrane antigen-positron emission tomography/computed tomography in advanced prostate cancer: Current state and future trends. PROSTATE INTERNATIONAL, 5 (4), pp.125-129. https://doi.org/10.1016/j.prnil.2017.02.003.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/259175
    DOI
    10.1016/j.prnil.2017.02.003
    Abstract
    The early and accurate detection of prostate cancer is important to ensure timely management and appropriate individualized treatment. Currently, conventional imaging has limitations particularly in the early detection of metastases and at prostate-specific antigen (PSA) levels < 2.0 ng/mL. Furthermore, disease management such as salvage radiotherapy is best at low PSA levels. Thus, it is critical to capture the disease in the oligometastatic stage as disease progression and commencement of systemic therapies can be delayed by metastasis-directed therapy. Prostate-specific membrane antigen (PSMA) is overexpressed in prostatic cancer cells. Novel imaging modalities using radiolabeled tracers with PSMA such as 68Ga-PSMA-positron emission tomography (PET)/computed tomography (CT) have shown promising results. We review the literature regarding 68Ga-PSMA-PET/CT in the setting of primary prostate cancer and biochemical recurrence. At present, the best utilization of 68Ga-PSMA-PET/CT appears to be in biochemical recurrence. 68Ga-PSMA-PET/CT has high diagnostic accuracy for lymph node metastases and has been shown to have superior detection rates to conventional imaging, especially at low PSA levels. The exact role of 68Ga-PSMA-PET/CT in primary prostate cancer is not yet entirely clear. It has an improved detection rate for smaller lesions and may be able to identify nodal or distant metastatic disease at an earlier stage. While still experimental, there may also be value in combining 68Ga-PSMA-PET to multiparametric magnetic resonance imaging for staging of intraprostatic disease. To date, 68Ga-PSMA-PET/CT has been shown to have considerable clinical value and to impact treatment selection for patients with prostate cancer. Still in its infancy, the results of future clinical trials will be excitedly awaited.

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