[Procedure Guideline for Prostate Cancer Imaging with PSMA-ligand PET/CT].

Afshar-Oromieh, Ali; Eiber, Matthias; Fendler, Wolfgang; Schmidt, Matthias; Rahbar, Kambiz; Ahmadzadehfar, Hojjat; Umutlu, Lale; Hadaschik, Boris; Hakenberg, Oliver W; Fornara, Paolo; Kurth, Jens; Neels, O; Wester, Hans-Jürgen; Schwaiger, Markus; Kopka, Klaus; Haberkorn, Uwe; Herrmann, Ken; Krause, Bernd J (2023). [Procedure Guideline for Prostate Cancer Imaging with PSMA-ligand PET/CT]. Nuklearmedizin, 62(1), pp. 5-19. Thieme 10.1055/a-1984-8167

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PSMA-PET/CT for imaging prostate cancer (PC) has spread worldwide since its clinical introduction in 2011. The majority of experiences have been collected for PSMA-PET-imaging of recurrent PC. Data for primary staging of high-risk PC are highly promising. Meanwhile, a plethora of PSMA-ligands are available for clinical use (e. g. 68Ga-PSMA-11, 68Ga-PSMA-I&T, 68Ga-PSMA-617, 18F-DCFBC, 18F-DCFPyL, 18F-PSMA-1007, 18F-rhPSMA-7 and 18F-JK-PSMA-7). However, an official approval is available only for 68Ga-PSMA-11 (approved by the US FDA in 2020) and 18F-DCFPyL (approved by the US FDA in 2021).Recommendations for acquisition times vary from 1-2 h p. i. It has been shown that for the majority of tumour lesions, the contrast in PSMA-PET/CT increases with time. Therefore, additional late imaging can help to clarify unclear findings. PSMA-PET/CT should be performed prior to commencing an androgen deprivation therapy (ADT) since (long term) ADT reduces the visibility of PC lesions. Following injection of PSMA-ligands, hydration and forced diuresis are recommended for PSMA-ligands with primarily excretion via the kidneys in order to increase the visibility of tumour lesions adjacent to the urinary bladder.PSMA-ligands are physiologically taken up in multiple normal organs. For some 18F-labelled PSMA-ligands, presence of unspecific focal bone uptake has been reported. When using these tracers, focal bone uptake without CT-correlate should be interpreted with great caution. Besides prostate cancer, practically all solid tumors express PSMA in their neovasculature thereby taking up PSMA-ligands, although usually at a lower extent compared to PC. Also multiple benign lesions and inflammatory processes (e. g. lymph nodes) take up PSMA-ligands, also usually at lower extent compared to PC.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine
UniBE Contributor:	Afshar Oromieh, Ali
Subjects:	600 Technology > 610 Medicine & health
ISSN:	2567-6407
Publisher:	Thieme
Language:	German
Submitter:	Pubmed Import
Date Deposited:	07 Feb 2023 12:25
Last Modified:	07 Feb 2023 23:27
Publisher DOI:	10.1055/a-1984-8167
PubMed ID:	36746147
URI:	https://boris.unibe.ch/id/eprint/178442