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Cancers
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PSMA PET/CT in Prostate Cancer
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PSMA PET/CT in Prostate Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (20 November 2024) | Viewed by 7062

Special Issue Editor

Dr. Henry Hyunshik Woo

E-Mail Website
Guest Editor
Department of Urology, Chris O’Brien Lifehouse, Sydney, NSW 2050, Australia
Interests: PSMA PET; prostate cancer; prostatic obstruction

Special Issue Information

Dear Colleagues,

The introduction of PSMA PET/CT into clinical use has had a major impact on our management of prostate cancer. Its initial utilization was in the identification of disease in biochemical recurrence and, shortly after that, it became recognized as a superior tool in primary staging at diagnosis. The potential roles of PSMA PET/CT continue to expand and there is growing data to demonstrate its utility in the assessment of local disease. As such, there are emerging data that demonstrate its utility in diagnosis, active surveillance, and as a biomarker. This novel imaging has also paved the way for a therapeutic option and the exponential growth of interest in theranostics.

We are pleased to invite you to contribute manuscripts that provide emerging or mature data on how PSMA PET/CT has influenced prostate cancer management in your institution or systematically evaluate the research experience in specific applications of PSMA PET/CT. The aim of this Special Issue is to create a collection of papers that define the use of this novel form of imaging in urological clinical practice.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Diagnosis
  • Staging
  • Re-staging
  • Predictive disease states
  • Imaging biomarker

I look forward to receiving your contributions.

Dr. Henry Hyunshik Woo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • staging
  • diagnosis
  • radical prostatectomy
  • biochemical recurrence

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Published Papers (4 papers)

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Research

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19 pages, 4691 KiB  
Article
From Despair to Hope: First Arabic Experience of 177Lu-PSMA and 161Tb-PSMA Therapy for Metastatic Castration-Resistant Prostate Cancer
by Akram Al-Ibraheem, Ahmed Saad Abdlkadir, Deya’ Aldeen Sweedat, Stephan Maus, Ula Al-Rasheed, Samer Salah, Fadi Khriesh, Diyaa Juaidi, Dina Abu Dayek, Feras Istatieh, Farah Anwar, Aisha Asrawi, Alaa Abufara, Mohammad Al-Rwashdeh, Ramiz Abu-Hijlih, Baha’ Sharaf, Rami Ghanem, Hikmat Abdel-Razeq and Asem Mansour
Cancers 2024, 16(11), 1974; https://doi.org/10.3390/cancers16111974 - 23 May 2024
Cited by 5 | Viewed by 2596
Abstract
The objective of this retrospective study is to assess the effectiveness and safety of two beta-emitting prostate-specific membrane antigen (PSMA) radioligands, [177Lu]Lu and [161Tb]Tb, in heavily treated patients with metastatic castration-resistant prostate cancer (mCRPC). A total of 148 cycles of beta-emitting [...] Read more.
The objective of this retrospective study is to assess the effectiveness and safety of two beta-emitting prostate-specific membrane antigen (PSMA) radioligands, [177Lu]Lu and [161Tb]Tb, in heavily treated patients with metastatic castration-resistant prostate cancer (mCRPC). A total of 148 cycles of beta-emitting PSMA radioligand therapy were given to 53 patients at a specialized cancer care center in Amman, Jordan. This treatment was offered following the exhaustion of all prior treatment modalities. Approximately half of the cases (n = 26) demonstrated an initial partial response to PSMA radioligand therapy. Moreover, roughly one-fourth of the patients (n = 13) exhibited a sustained satisfactory biochemical response, which qualified them to receive a total of six PSMA radioligand therapy cycles and maintain continued follow-up for additional treatment cycles. This was reflected by an adequate prostate-specific antigen (PSA) decline and a concomitant partial response evident on [68Ga]Ga-PSMA positron emission tomography/computed tomography imaging. A minority of patients (n= 18; 34%) experienced side effects. Generally, these were low-grade and self-limiting toxicities. This study endorses previous research evidence about PSMA radioligand therapy’s safety and efficacy. It also provides the first clinical insight from patients of Arab ethnicity. This should facilitate and promote further evidence, both regionally and internationally. Full article
(This article belongs to the Special Issue PSMA PET/CT in Prostate Cancer)
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Review

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16 pages, 705 KiB  
Review
The Role of 18F PSMA-1007 PET/CT in the Staging and Detection of Recurrence of Prostate Cancer, A Scoping Review
by David Armany, Lequang Vo, Duncan Self, Sriskanthan Baskaranathan, Tania Hossack, Simon Bariol, David Ende and Henry Hyunshik Woo
Cancers 2025, 17(6), 1049; https://doi.org/10.3390/cancers17061049 - 20 Mar 2025
Viewed by 530
Abstract
Background: To determine and review the currently available literature behind the staging capabilities of 18F-PSMA-1007 PET/CT in the setting of initial staging and detection of recurrent disease for patients with prostate cancer. Prostate cancer (PCa), one of the most diagnosed malignancies affecting adult [...] Read more.
Background: To determine and review the currently available literature behind the staging capabilities of 18F-PSMA-1007 PET/CT in the setting of initial staging and detection of recurrent disease for patients with prostate cancer. Prostate cancer (PCa), one of the most diagnosed malignancies affecting adult men worldwide, requires accurate staging and early detection of recurrent disease to guide treatment decisions and improve oncological outcomes. 18F-PSMA-1007 PET/CT is a novel radiotracer with favorable imaging characteristics suggesting an important role within the Prostate Cancer management landscape. Methods: The Arksey and O’Malley Framework was used to guide this review. PubMed/MEDLINE, EMBASE, EBSCO, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were used, and relevant titles were screened for eligibility. Results: 404 database results were returned; 343 titles were excluded due to irrelevance and duplicates. A total of 61 papers were included for title and abstract review with a subsequent 26 excluded due to not meeting the inclusion criteria. A total of 35 papers proceeded to full-text review and 35 papers were included in this review. Evidence was grouped under three major themes: (1) The role of 18F-PSMA-1007 PET/CT in Initial staging; (2) The role of 18F-PSMA-1007 PET/CT in the detection of recurrent Prostate Cancer and (3) The Role of 18F-PSMA-1007 PET/CT in Salvage Therapy. The findings suggest 18F-PSMA-1007 PET/CT has superior diagnostic accuracy and sensitivity for the initial staging of prostate cancer compared with conventional imaging and other commonly used radiotracers. Strengths included the detection of pelvic and locoregional disease. Limitations included poor specificity for the detection of bone lesions, inconsistent urinary excretion patterns, and high inter-reader variability. Conclusions: 18F-PSMA-1007 PET/CT demonstrates superior diagnostic accuracy and sensitivity in both initial staging and detection of prostate cancer recurrence; however, it is limited by poor specificity for bone lesions and inconsistent urinary excretion patterns. Prospective multicenter trials are required to clearly delineate its role in the initial staging of prostate cancer and detection of recurrent disease. Full article
(This article belongs to the Special Issue PSMA PET/CT in Prostate Cancer)
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12 pages, 1250 KiB  
Review
Management Based on Pretreatment PSMA PET of Patients with Localized High-Risk Prostate Cancer Part 2: Prediction of Recurrence—A Systematic Review and Meta-Analysis
by Manuela Andrea Hoffmann, Cigdem Soydal, Irene Virgolini, Murat Tuncel, Kalevi Kairemo, Daniel S. Kapp and Finn Edler von Eyben
Cancers 2025, 17(5), 841; https://doi.org/10.3390/cancers17050841 - 28 Feb 2025
Viewed by 738
Abstract
Background and objectives: For patients with prostate cancer (PCa), PSMA PET better diagnose metastases than conventional imaging. In a systematic review and meta-analysis (INPLASY register, 2024311004), we aimed to summarize findings with pretreatment PSMA PET in patients with PCa that was localized according [...] Read more.
Background and objectives: For patients with prostate cancer (PCa), PSMA PET better diagnose metastases than conventional imaging. In a systematic review and meta-analysis (INPLASY register, 2024311004), we aimed to summarize findings with pretreatment PSMA PET in patients with PCa that was localized according to conventional imaging and summarize how pretreatment PSMA PET had influence on biochemical recurrence (BCR)-free survival and overall survival (OS). Methods: We searched for publications in Pubmed, Google Scholar, ClinicalTrials.gov, and reference lists between 2016 and February 2025. We summarized biochemical recurrence-free survival in Forest plots. Results: Nine publications reported 1908 patients and showed that pretreatment PSMA PET was associated with survival. Three publications reported that pretreatment PSMA PET gave better 3–5-year BCR-free survival than conventional imaging (74% versus 57%). Two publications reported PSMA PET-risk for 389 patients. Those with PSMA PET-low-risk lived 5 years longer often than those with PSMA PET high-risk (84% versus 20%). Conclusions: Pretreatment PSMA PET is widely used in the real world. Pretreatment PSMA PET supports personalized treatment and may explain why pretreatment PSMA PET improved BCR-free survival and OS. It is believed that pretreatment PSMA PET may facilitate future progress in care of patients with high-risk PCa. Full article
(This article belongs to the Special Issue PSMA PET/CT in Prostate Cancer)
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24 pages, 1178 KiB  
Review
Current Clinical Applications of PSMA-PET for Prostate Cancer Diagnosis, Staging, and Treatment
by Franz von Stauffenberg, Cédric Poyet, Stephan Beintner-Skawran, Alexander Maurer and Florian A. Schmid
Cancers 2024, 16(24), 4263; https://doi.org/10.3390/cancers16244263 - 21 Dec 2024
Cited by 2 | Viewed by 2630
Abstract
Over the past decade, prostate-specific membrane antigen positron emission tomography (PSMA-PET) has revolutionized prostate cancer (PCa) imaging, offering greater sensitivity and specificity compared to conventional imaging modalities such as CT, MRI, and bone scintigraphy. PSMA-PET is particularly valuable in staging newly diagnosed patients [...] Read more.
Over the past decade, prostate-specific membrane antigen positron emission tomography (PSMA-PET) has revolutionized prostate cancer (PCa) imaging, offering greater sensitivity and specificity compared to conventional imaging modalities such as CT, MRI, and bone scintigraphy. PSMA-PET is particularly valuable in staging newly diagnosed patients with intermediate- and high-risk disease, detecting biochemical recurrence, and evaluating metastatic cases. By utilizing radiotracers that accumulate specifically in PSMA-expressing cells, even small metastases can be detected, offering a detailed assessment of cancer extent and enabling more targeted diagnostic evaluations. Among the most utilized radiotracers, [68Ga]- and [18F]-labeled PSMA tracers enable precise imaging even with low disease burden. This diagnostic precision also supports advanced therapeutic approaches, including metastasis-directed therapy for oligometastatic cases and systemic treatment options, such as radioligand therapy, which presents new treatment perspectives for metastatic, castration-resistant PCa. This review examines the evolution of PSMA-PET in the diagnostics and therapy of PCa while comparing the current recommendations from leading clinical guidelines. The integration of PSMA-PET into clinical practice has redefined the management of PCa, improving diagnostic accuracy and enabling personalized treatment strategies, while lacking prospective long-term outcome data. As PSMA-PET continues to expand in clinical application, this review highlights its significant advancements while critically addressing limitations to ensure balanced and evidence-based implementation in prostate cancer care. Full article
(This article belongs to the Special Issue PSMA PET/CT in Prostate Cancer)
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