Research progress on prostate-specific membrane antigen ligand positron emission tomography imaging of prostate cancer_Journal of Biomedical Engineering

Authors：

LI Yuqin ¹ , LIU Bin ¹ , YUAN Yongxin ² ,  QIN Wei ¹

1. Department of Nuclear Medicine, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;
2. Department of Anorectal, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;

Corresponding author：

Keywords：

Prostate cancer; Prostate specific membrane antigen; Positron emission tomography; Biochemical recurrence

DOI：

10.7507/1001-5515.202112035

Video：

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Prostate cancer is the most common malignant tumor in male urinary system, and the morbidity and mortality rate are increasing year by year. Traditional imaging examinations have some limitations in the diagnosis of prostate cancer, and the advent of molecular imaging probes and imaging technology have provided new ideas for the integration of diagnosis and treatment of prostate cancer. In recent years, prostate-specific membrane antigen (PSMA) has attracted much attention as a target for imaging and treatment of prostate cancer. PSMA ligand positron emission tomography (PET) has important reference value in the diagnosis, initial staging, detection of biochemical recurrence and metastasis, clinical decision-making guidance and efficacy evaluation of prostate cancer. This article briefly reviews the clinical research and application progress on PSMA ligand PET imaging in prostate cancer in recent years, so as to raise the efficiency of clinical applications.

Citation： LI Yuqin, LIU Bin, YUAN Yongxin, QIN Wei. Research progress on prostate-specific membrane antigen ligand positron emission tomography imaging of prostate cancer. Journal of Biomedical Engineering, 2022, 39(6): 1263-1268. doi: 10.7507/1001-5515.202112035 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Feng R M, Zong Y N, Cao S M, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?. Cancer Commun (Lond), 2019, 39(1): 22.
3.	Kendrick J, Francis R, Hassan G M, et al. Radiomics for identification and prediction in metastatic prostate cancer: a review of studies. Front Oncol, 2021, 11: 771787.
4.	Eapen R S, Nzenza T C, Murphy D G, et al. PSMA PET applications in the prostate cancer journey: from diagnosis to theranostics. World J Urol, 2019, 37(7): 1255-1261.
5.	Morris K E, Grimberg D, Arcot R, et al. Aggressive prostate cancer masquerading as acute prostatitis. Can J Urol, 2021, 28(4): 10799-10801.
6.	Petersen L J, Zacho H D. PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review. Cancer Imaging, 2020, 20(1): 10.
7.	Chavoshi M, Mirshahvalad S A, Metser U, et al. 68Ga-PSMA PET in prostate cancer: a systematic review and meta-analysis of the observer agreement. Eur J Nucl Med Mol Imaging, 2022, 49(3): 1021-1029.
8.	Shagera Q A, Artigas C, Karfis I, et al. 68Ga-PSMA PET/CT for response assessment and outcome prediction in metastatic prostate cancer patients treated with taxane-based chemotherapy. J Nucl Med, 2022, 63(8): 1191-1198.
9.	Ware R E, Williams S, Hicks R J. Molecular imaging of recurrent and metastatic prostate cancer. Semin Nucl Med, 2019, 49(4): 280-293.
10.	Eiber M, Fendler W P, Rowe S P, et al. Prostate-specific membrane antigen ligands for imaging and therapy. J Nucl Med, 2017, 58(Suppl 2): 67S-76S.
11.	Kuten J, Fahoum I, Savin Z, et al. Head-to-head comparison of 68Ga-PSMA-11 with 18F-PSMA-1007 PET/CT in staging prostate cancer using histopathology and immunohistochemical analysis as a reference standard. J Nucl Med, 2020, 61(4): 527-532.
12.	Patel P, Wang S, Siddiqui M M. The use of multiparametric magnetic resonance imaging (mpMRI) in the detection, evaluation, and surveillance of clinically significant prostate cancer (csPCa). Curr Urol Rep, 2019, 20(10): 60.
13.	Park S Y, Zacharias C, Harrison C, et al. Gallium 68 PSMA-11 PET/MR imaging in patients with intermediate- or high-risk prostate cancer. Radiology, 2018, 288(2): 495-505.
14.	Liu F Y, Sheng T W, Tseng J R, et al. Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET/CT vs PET/MRI. Br J Radiol, 2022, 95(1131): 20210728.
15.	刘大亮, 李国权, 陈玲, 等. 68Ga-PSMA-617 PET/CT与多参数MRI诊断前列腺癌的对比研究. 中华核医学与分子影像杂志, 2019, 39(2): 72-76.
16.	Hu X, Wu Y, Yang P, et al. Performance of 68Ga-labeled prostate-specific membrane antigen ligand positron emission tomography/computed tomography in the diagnosis of primary prostate cancer: a systematic review and meta-analysis. Int Braz J Urol, 2022, 48(6): 891-902.
17.	Rahbar K, Weckesser M, Huss S, et al. Correlation of intraprostatic tumor extent with ⁶⁸Ga-PSMA distribution in patients with prostate cancer. J Nucl Med, 2016, 57(4): 563-567.
18.	武鹏, 田春娟, 马帅军, 等. 68Ga-PSMA PET/CT在前列腺癌门诊筛查中的临床价值. 中华泌尿外科杂志, 2022, 43(7): 495-499.
19.	李亚健, 彭博施张, 王远卓, 等. 68Ga-PSMA PET/CT在前列腺癌术前诊断及手术策略制订中的应用. 中华泌尿外科杂志, 2021, 42(1): 12-17.
20.	Malaspina S, Anttinen M, Taimen P, et al. Prospective comparison of 18F-PSMA-1007 PET/CT, whole-body MRI and CT in primary nodal staging of unfavourable intermediate- and high-risk prostate cancer. Eur J Nucl Med Mol Imaging, 2021, 48(9): 2951-2959.
21.	Kim S J, Lee S W, Ha H K. Diagnostic performance of radiolabeled prostate-specific membrane antigen positron emission tomography/computed tomography for primary lymph node staging in newly diagnosed intermediate to high-risk prostate cancer patients: a systematic review and meta-analysis. Urol Int, 2019, 102(1): 27-36.
22.	Hofman M S, Lawrentschuk N, Francis R J, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet, 2020, 395(10231): 1208-1216.
23.	Esen T, Kilic M, Seymen H, et al. Can Ga-68 PSMA PET/CT replace conventional imaging modalities for primary lymph node and bone staging of prostate cancer?. Eur Urol Focus, 2020, 6(2): 218-220.
24.	Zacho H D, Ravn S, Afshar-Oromieh A, et al. Added value of 68Ga-PSMA PET/CT for the detection of bone metastases in patients with newly diagnosed prostate cancer and a previous 99mTc bone scintigraphy. EJNMMI Res, 2020, 10(1): 31.
25.	黎翔, 杨卫东, 汪静. PSMA配体的前列腺癌PET显像. 中华核医学与分子影像杂志, 2019, 39(2): 121-128.
26.	Zhao R, Li Y, Nie L, et al. The meta-analysis of the effect of 68Ga-PSMA-PET/CT diagnosis of prostatic cancer compared with bone scan. Medicine (Baltimore), 2021, 100(15): e25417.
27.	Dadgar H, Emami F, Norouzbeigi N, et al. Application of [68Ga]PSMA PET/CT in diagnosis and management of prostate cancer patients. Mol Imaging Biol, 2020, 22(4): 1062-1069.
28.	Liu F, Dong J, Shen Y, et al. Comparison of PET/CT and MRI in the diagnosis of bone metastasis in prostate cancer patients: a network analysis of diagnostic studies. Front Oncol, 2021, 11: 736654.
29.	Schiavina R, Chessa F, Borghesi M, et al. State-of-the-art imaging techniques in the management of preoperative staging and re-staging of prostate cancer. Int J Urol, 2019, 26(1): 18-30.
30.	Wang R, Shen G, Huang M, et al. The diagnostic role of 18F-choline, 18F-fluciclovine and 18F-PSMA PET/CT in the detection of prostate cancer with biochemical recurrence: a meta-analysis. Front Oncol, 2021, 11: 684629.
31.	Martinez J, Subramanian K, Margolis D, et al. 68Ga-PSMA-HBED-CC PET/MRI is superior to multiparametric magnetic resonance imaging in men with biochemical recurrent prostate cancer: A prospective single-institutional study. Transl Oncol, 2021, 15(1): 101242.
32.	Joshi A, Roberts M J, Perera M, et al. The clinical efficacy of PSMA PET/MRI in biochemically recurrent prostate cancer compared with standard of care imaging modalities and confirmatory histopathology: results of a single-centre, prospective clinical trial. Clin Exp Metastasis, 2020, 37(4): 551-560.
33.	Abufaraj M, Grubmuller B, Zeitlinger M, et al. Prospective evaluation of the performance of [68Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy. Eur J Nucl Med Mol Imaging, 2019, 46(10): 2169-2177.
34.	Jentjens S, Mai C, Ahmadi B N, et al. Prospective comparison of simultaneous [68Ga]Ga-PSMA-11 PET/MR versus PET/CT in patients with biochemically recurrent prostate cancer. Eur Radiol, 2022, 32(2): 901-911.
35.	Ekmekcioglu O, Busstra M, Klass N D, et al. Bridging the imaging gap: PSMA PET/CT has a high impact on treatment planning in prostate cancer patients with biochemical recurrence-a narrative review of the literature. J Nucl Med, 2019, 60(10): 1394-1398.
36.	Rousseau C, Le Thiec M, Ferrer L, et al. Preliminary results of a 68Ga-PSMA PET/CT prospective study in prostate cancer patients with occult recurrence: diagnostic performance and impact on therapeutic decision-making. Prostate, 2019, 79(13): 1514-1522.
37.	Barbaud M, Frindel M, Ferrer L, et al. 68Ga-PSMA-11 PET-CT study in prostate cancer patients with biochemical recurrence and non-contributive ^18FCholine PET-CT: impact on therapeutic decision-making and biomarker changes. Prostate, 2019, 79(5): 454-461.
38.	Haxhimolla J, Kua B, Gilbourd D, et al. PSMA PET scan era: a changing paradigm PSMA PET and lymph node dissection for prostate cancer management. Semin Oncol Nurs, 2020, 36(4): 151044.
39.	Hruby G, Eade T, Emmett L, et al. 68Ga-PSMA-PET/CT staging prior to definitive radiation treatment for prostate cancer. Asia Pac J Clin Oncol, 2018, 14(4): 343-346.
40.	Bettermann A S, Zamboglou C, Kiefer S, et al. [68Ga-]PSMA-11 PET/CT and multiparametric MRI for gross tumor volume delineation in a slice by slice analysis with whole mount histopathology as a reference standard-implications for focal radiotherapy planning in primary prostate cancer. Radiother Oncol, 2019, 141: 214-219.
41.	Cerci J J, Fanti S, Lobato E E, et al. Diagnostic performance and clinical impact of 68Ga-PSMA-11 PET/CT imaging in early relapsed prostate cancer after radical therapy: a prospective multicenter study (IAEA-PSMA Study). J Nucl Med, 2022, 63(2): 240-247.
42.	Karyagar S, Guven O, Karyagar S S, et al. Can 68Ga-PSMA PET/CT-derived prostate-specific membrane antigen expression parameters predict prostate-specific antigen response to enzalutamide treatment?. Nucl Med Commun, 2021, 42(9): 1011-1016.
43.	Cornford P, van den Bergh R C N, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II-2020 update: treatment of relapsing and metastatic prostate cancer. Eur Urol, 2021, 79(2): 263-282.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Feng R M, Zong Y N, Cao S M, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?. Cancer Commun (Lond), 2019, 39(1): 22.
3. Kendrick J, Francis R, Hassan G M, et al. Radiomics for identification and prediction in metastatic prostate cancer: a review of studies. Front Oncol, 2021, 11: 771787.
4. Eapen R S, Nzenza T C, Murphy D G, et al. PSMA PET applications in the prostate cancer journey: from diagnosis to theranostics. World J Urol, 2019, 37(7): 1255-1261.
5. Morris K E, Grimberg D, Arcot R, et al. Aggressive prostate cancer masquerading as acute prostatitis. Can J Urol, 2021, 28(4): 10799-10801.
6. Petersen L J, Zacho H D. PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review. Cancer Imaging, 2020, 20(1): 10.
7. Chavoshi M, Mirshahvalad S A, Metser U, et al. 68Ga-PSMA PET in prostate cancer: a systematic review and meta-analysis of the observer agreement. Eur J Nucl Med Mol Imaging, 2022, 49(3): 1021-1029.
8. Shagera Q A, Artigas C, Karfis I, et al. 68Ga-PSMA PET/CT for response assessment and outcome prediction in metastatic prostate cancer patients treated with taxane-based chemotherapy. J Nucl Med, 2022, 63(8): 1191-1198.
9. Ware R E, Williams S, Hicks R J. Molecular imaging of recurrent and metastatic prostate cancer. Semin Nucl Med, 2019, 49(4): 280-293.
10. Eiber M, Fendler W P, Rowe S P, et al. Prostate-specific membrane antigen ligands for imaging and therapy. J Nucl Med, 2017, 58(Suppl 2): 67S-76S.
11. Kuten J, Fahoum I, Savin Z, et al. Head-to-head comparison of 68Ga-PSMA-11 with 18F-PSMA-1007 PET/CT in staging prostate cancer using histopathology and immunohistochemical analysis as a reference standard. J Nucl Med, 2020, 61(4): 527-532.
12. Patel P, Wang S, Siddiqui M M. The use of multiparametric magnetic resonance imaging (mpMRI) in the detection, evaluation, and surveillance of clinically significant prostate cancer (csPCa). Curr Urol Rep, 2019, 20(10): 60.
13. Park S Y, Zacharias C, Harrison C, et al. Gallium 68 PSMA-11 PET/MR imaging in patients with intermediate- or high-risk prostate cancer. Radiology, 2018, 288(2): 495-505.
14. Liu F Y, Sheng T W, Tseng J R, et al. Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET/CT vs PET/MRI. Br J Radiol, 2022, 95(1131): 20210728.
15. 刘大亮, 李国权, 陈玲, 等. 68Ga-PSMA-617 PET/CT与多参数MRI诊断前列腺癌的对比研究. 中华核医学与分子影像杂志, 2019, 39(2): 72-76.
16. Hu X, Wu Y, Yang P, et al. Performance of 68Ga-labeled prostate-specific membrane antigen ligand positron emission tomography/computed tomography in the diagnosis of primary prostate cancer: a systematic review and meta-analysis. Int Braz J Urol, 2022, 48(6): 891-902.
17. Rahbar K, Weckesser M, Huss S, et al. Correlation of intraprostatic tumor extent with ⁶⁸Ga-PSMA distribution in patients with prostate cancer. J Nucl Med, 2016, 57(4): 563-567.
18. 武鹏, 田春娟, 马帅军, 等. 68Ga-PSMA PET/CT在前列腺癌门诊筛查中的临床价值. 中华泌尿外科杂志, 2022, 43(7): 495-499.
19. 李亚健, 彭博施张, 王远卓, 等. 68Ga-PSMA PET/CT在前列腺癌术前诊断及手术策略制订中的应用. 中华泌尿外科杂志, 2021, 42(1): 12-17.
20. Malaspina S, Anttinen M, Taimen P, et al. Prospective comparison of 18F-PSMA-1007 PET/CT, whole-body MRI and CT in primary nodal staging of unfavourable intermediate- and high-risk prostate cancer. Eur J Nucl Med Mol Imaging, 2021, 48(9): 2951-2959.
21. Kim S J, Lee S W, Ha H K. Diagnostic performance of radiolabeled prostate-specific membrane antigen positron emission tomography/computed tomography for primary lymph node staging in newly diagnosed intermediate to high-risk prostate cancer patients: a systematic review and meta-analysis. Urol Int, 2019, 102(1): 27-36.
22. Hofman M S, Lawrentschuk N, Francis R J, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet, 2020, 395(10231): 1208-1216.
23. Esen T, Kilic M, Seymen H, et al. Can Ga-68 PSMA PET/CT replace conventional imaging modalities for primary lymph node and bone staging of prostate cancer?. Eur Urol Focus, 2020, 6(2): 218-220.
24. Zacho H D, Ravn S, Afshar-Oromieh A, et al. Added value of 68Ga-PSMA PET/CT for the detection of bone metastases in patients with newly diagnosed prostate cancer and a previous 99mTc bone scintigraphy. EJNMMI Res, 2020, 10(1): 31.
25. 黎翔, 杨卫东, 汪静. PSMA配体的前列腺癌PET显像. 中华核医学与分子影像杂志, 2019, 39(2): 121-128.
26. Zhao R, Li Y, Nie L, et al. The meta-analysis of the effect of 68Ga-PSMA-PET/CT diagnosis of prostatic cancer compared with bone scan. Medicine (Baltimore), 2021, 100(15): e25417.
27. Dadgar H, Emami F, Norouzbeigi N, et al. Application of [68Ga]PSMA PET/CT in diagnosis and management of prostate cancer patients. Mol Imaging Biol, 2020, 22(4): 1062-1069.
28. Liu F, Dong J, Shen Y, et al. Comparison of PET/CT and MRI in the diagnosis of bone metastasis in prostate cancer patients: a network analysis of diagnostic studies. Front Oncol, 2021, 11: 736654.
29. Schiavina R, Chessa F, Borghesi M, et al. State-of-the-art imaging techniques in the management of preoperative staging and re-staging of prostate cancer. Int J Urol, 2019, 26(1): 18-30.
30. Wang R, Shen G, Huang M, et al. The diagnostic role of 18F-choline, 18F-fluciclovine and 18F-PSMA PET/CT in the detection of prostate cancer with biochemical recurrence: a meta-analysis. Front Oncol, 2021, 11: 684629.
31. Martinez J, Subramanian K, Margolis D, et al. 68Ga-PSMA-HBED-CC PET/MRI is superior to multiparametric magnetic resonance imaging in men with biochemical recurrent prostate cancer: A prospective single-institutional study. Transl Oncol, 2021, 15(1): 101242.
32. Joshi A, Roberts M J, Perera M, et al. The clinical efficacy of PSMA PET/MRI in biochemically recurrent prostate cancer compared with standard of care imaging modalities and confirmatory histopathology: results of a single-centre, prospective clinical trial. Clin Exp Metastasis, 2020, 37(4): 551-560.
33. Abufaraj M, Grubmuller B, Zeitlinger M, et al. Prospective evaluation of the performance of [68Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy. Eur J Nucl Med Mol Imaging, 2019, 46(10): 2169-2177.
34. Jentjens S, Mai C, Ahmadi B N, et al. Prospective comparison of simultaneous [68Ga]Ga-PSMA-11 PET/MR versus PET/CT in patients with biochemically recurrent prostate cancer. Eur Radiol, 2022, 32(2): 901-911.
35. Ekmekcioglu O, Busstra M, Klass N D, et al. Bridging the imaging gap: PSMA PET/CT has a high impact on treatment planning in prostate cancer patients with biochemical recurrence-a narrative review of the literature. J Nucl Med, 2019, 60(10): 1394-1398.
36. Rousseau C, Le Thiec M, Ferrer L, et al. Preliminary results of a 68Ga-PSMA PET/CT prospective study in prostate cancer patients with occult recurrence: diagnostic performance and impact on therapeutic decision-making. Prostate, 2019, 79(13): 1514-1522.
37. Barbaud M, Frindel M, Ferrer L, et al. 68Ga-PSMA-11 PET-CT study in prostate cancer patients with biochemical recurrence and non-contributive ^18FCholine PET-CT: impact on therapeutic decision-making and biomarker changes. Prostate, 2019, 79(5): 454-461.
38. Haxhimolla J, Kua B, Gilbourd D, et al. PSMA PET scan era: a changing paradigm PSMA PET and lymph node dissection for prostate cancer management. Semin Oncol Nurs, 2020, 36(4): 151044.
39. Hruby G, Eade T, Emmett L, et al. 68Ga-PSMA-PET/CT staging prior to definitive radiation treatment for prostate cancer. Asia Pac J Clin Oncol, 2018, 14(4): 343-346.
40. Bettermann A S, Zamboglou C, Kiefer S, et al. [68Ga-]PSMA-11 PET/CT and multiparametric MRI for gross tumor volume delineation in a slice by slice analysis with whole mount histopathology as a reference standard-implications for focal radiotherapy planning in primary prostate cancer. Radiother Oncol, 2019, 141: 214-219.
41. Cerci J J, Fanti S, Lobato E E, et al. Diagnostic performance and clinical impact of 68Ga-PSMA-11 PET/CT imaging in early relapsed prostate cancer after radical therapy: a prospective multicenter study (IAEA-PSMA Study). J Nucl Med, 2022, 63(2): 240-247.
42. Karyagar S, Guven O, Karyagar S S, et al. Can 68Ga-PSMA PET/CT-derived prostate-specific membrane antigen expression parameters predict prostate-specific antigen response to enzalutamide treatment?. Nucl Med Commun, 2021, 42(9): 1011-1016.
43. Cornford P, van den Bergh R C N, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II-2020 update: treatment of relapsing and metastatic prostate cancer. Eur Urol, 2021, 79(2): 263-282.

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