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Minerva Urology and Nephrology 2021 February;73(1):32-41

DOI: 10.23736/S2724-6051.20.03739-X


lingua: Inglese

Prostate specific membrane antigen positron emission tomography/computed tomography and staging high risk prostate cancer: a non-systematic review of high clinical impact literature

Joshua J. MORIGI 1 , Jack ANDERSON 1, Cosimo DE NUNZIO 2, Stefano FANTI 3

1 Unit of Positron Emission Tomography and Computed Tomography, Royal Darwin Hospital, Darwin, Australia; 2 Sant’Andrea Hospital, Sapienza University, Rome, Italy; 3 Unit of Metropolitan Nuclear Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

INTRODUCTION: Prostate specific membrane antigen (PSMA) positron emission tomography (PET) with computed tomography (CT) is a promising molecular imaging technique for prostate cancer (PCa). Although not yet included in international guidelines, PSMA PET/CT is commonly used in clinical practice to stage patients with newly diagnosed PCa. This review focuses on the most up-to-date literature on staging high-risk prostate cancer with PSMA PET/CT.
EVIDENCE ACQUISITION: An online based literature research encompassing original studies, reviews and meta-analysis was performed in the month of November of 2019. The most relevant and impactful research was then extracted based on the expertise of the authors, with the specific focus of highlighting the clinical impact and appropriateness of PSMA PET/CT in staging PCa.
EVIDENCE SYNTHESIS: The use of PSMA PET/CT is appropriate in all high-risk patients with newly diagnosed PCa as it will often have a significant clinical impact. Although preliminary findings are promising, there is still a scarcity of data regarding the performance of PSMA PET/CT vs. other modalities in defining disease within the prostate gland. There is good evidence suggesting that PSMA PET/CT may be superior to every other imaging modality in assessing loco-regional and distant metastatic disease.
CONCLUSIONS: PSMA PET/CT has the potential to become a gold standard in staging high risk prostate cancer, providing clinicians with accurate information on the extent of disease within the prostate and the presence of loco-regional and distant metastatic disease within a single scan.

KEY WORDS: Prostatic neoplasms; Molecular imaging; Positron emission tomography computed tomography

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