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Special Issue "PET Imaging in Prostate Cancer"

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A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 31 August 2023 | Viewed by 1987

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Special Issue Editors

Prof. Dr. Francesco Ceci

E-Mail Website
Guest Editor

Istituto Europeo di Oncologia, Milan, Italy
Interests: prostate cancer; positron emission tomography (PET); prostate-specific membrane antigen (PSMA); radio-ligand therapy; theranostics
Special Issues, Collections and Topics in MDPI journals

Dr. Giulia Marvaso

E-Mail Website
Co-Guest Editor

Department of Radiotherapy, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy
Interests: urological malignancies; radiation oncology; new fractionation protocols; treatment accuracy; patient’s quality of life; prognostic and predictive factors; SBRT hypofractionation; oligometastatic disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The introduction of molecular imaging, namely positron emission tomography (PET) imaging, in prostate cancer has already changed the clinical outcomes and therapeutic management of patients. PET imaging has proved to have higher diagnostic accuracy compared to conventional imaging, especially for staging high-risk patients and identifying metastatic locations in the case of disease recurrence. Several PET radiopharmaceuticals have been proposed over the last decade, and these diagnostic techniques are now currently placed under the umbrella term “new-generation imaging”.

The most successful approach is represented by targeting the prostate-specific membrane antigen (PSMA), and PSMA-PET has rapidly emerged as the new standard of care in prostate cancer. The main advantage of PSMA-PET is related to the high diagnostic accuracy and to the possibility to use it as therapeutic agent. PSMA can, in fact, be labeled to high energy isotopes (beta and alpha particles emitters) and used for radio-ligand therapy.

However, PSMA is not expressed in all prostate cancer cells, namely in the later stage of the disease when tumor heterogeneity is higher, and molecular pathways are more complex. Accordingly, metabolic PET imaging with radio-labelled choline or fluorodeoxyglucose still plays a role in prostate cancer. Furthermore, new targets have recently been explored, such as the fibroblast activation protein (FAPi-PET) bombesin (RM2-PET).

This Special Issue aims to collect original articles and reviews on the role of PET imaging in prostate cancer, with a special focus on innovative approaches and translational imaging.

Prof. Dr. Francesco Ceci
Dr. Giulia Marvaso
Guest Editors

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 short 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 2600 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

positron emission tomography
PET
prostate-specific membrane antigen (PSMA)
theranostics
radio-ligand therapy
choline
FDG
fibroblast activation protein
FAPi
bombesin
prostate cancer
image-guided therapy
PSMA-guided therapy

Published Papers (3 papers)

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Research

Open AccessArticle

Peering through the PSMA PET Lens: The Role of the European Association of Urology Biochemical Recurrence Risk Groups after Radical Prostatectomy

Henri Alexandre Bourgeno

and

Cancers 2023, 15(11), 2926; https://doi.org/10.3390/cancers15112926 - 26 May 2023

Viewed by 328

Abstract

(1) Background: The European Association of Urology (EAU) biochemical recurrence (BCR) risk grouping relies on data from historical cohorts that used conventional imaging techniques. In the era of PSMA PET/CT, we compared the patterns of positivity in the two risk groups and provided insight into positivity predictive factors. (2) Methods: Data from 1185 patients who underwent ⁶⁸Ga-PSMA-11PET/CT for BCR was analyzed, out of which 435 patients treated initially treated by radical prostatectomy were included in the final analysis. (3) Results: A significantly higher rate of positivity in the BCR high-risk group was observed (59% vs. 36%, p < 0.001). BCR low-risk group demonstrated more local (26% vs. 6%, p < 0.001) and oligometastatic (100% vs. 81%, p < 0.001) recurrences. The BCR risk group and PSA level at the time of PSMA PET/CT were independent predictive factors of positivity. (4) Conclusions: This study confirms that the EAU BCR risk groups have different rates of PSMA PET/CT positivity. Even with a lower rate in the BCR low-risk group, oligometastatic disease was 100% in those with distant metastases. Given the presence of discordant positivity and risk classification, integrating PSMA PET/CT positivity predictors into risk calculators for BCR might improve patient classification for subsequent treatment options. Future prospective studies are still needed to validate the above findings and assumptions. Full article

(This article belongs to the Special Issue PET Imaging in Prostate Cancer)

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Open AccessArticle

PSMA-PET Guided Treatment in Prostate Cancer Patients with Oligorecurrent Progression after Previous Salvage Treatment

Cancers 2023, 15(7), 2027; https://doi.org/10.3390/cancers15072027 - 29 Mar 2023

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Abstract

Background: Prostate Specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) is used to select recurrent prostate cancer (PCa) patients for metastases-directed therapy (MDT). We aimed to evaluate the oncologic outcomes of second-line PSMA-guided MDT in oligo-recurrent PCa patients. Methods: we performed a retrospective analysis of 113 recurrent PCa after previous radical prostatectomy and salvage therapies with oligorecurrent disease at PSMA-PET (≤3 lesions in N1/M1a-b) in three high-volume European centres. Patients underwent second-line salvage treatments: MDT targeted to PSMA (including surgery and/or radiotherapy), and the conventional approach (observation or Androgen Deprivation Therapy [ADT]). Patients were stratified according to treatments (MDT vs. conventional approach). Patients who underwent MDT were stratified according to stage in PSMA-PET (N1 vs. M1a-b). The primary outcome of the study was Progression-free survival (PFS). Secondary outcomes were Metastases-free survival (MFS) and Castration Resistant PCa free survival (CRPC-FS). Kaplan-Meier analyses assessed PFS, MFS and CRPC-FS. Multivariable Cox regression models identified predictors of progression and metastatic disease. Results: Overall, 91 (80%) and 22 (20%) patients were treated with MDT and the conventional approach, respectively. The median follow-up after PSMA-PET was 31 months. Patients who underwent MDT had a similar PFS compared to the conventional approach (p = 0.3). Individuals referred to MDT had significantly higher MFS and CRPC-FS compared to those who were treated with the conventional approach (73.5% and 94.7% vs. 30.5% and 79.5%; all p ≤ 0.001). In patients undergoing MDT, no significant differences were found for PFS and MFS according to N1 vs. M1a-b disease, while CRPC-FS estimates were significantly higher in patients with N1 vs. M1a-b (100% vs. 86.1%; p = 0.02). At multivariable analyses, age (HR = 0.96) and ADT during second line salvage treatment (HR = 0.5) were independent predictors of PFS; MDT (HR 0.27) was the only independent predictor of MFS (all p ≤ 0.04) Conclusion: Patients who underwent second-line PSMA-guided MDT experienced higher MFS and CRPC-FS compared to men who received conventional management. Full article

(This article belongs to the Special Issue PET Imaging in Prostate Cancer)

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Open AccessArticle

Detection Efficacy of ⁶⁸Ga-PSMA-11 PET/CT in Biochemical Recurrence of Prostate Cancer with Very Low PSA Levels: A 7-Year, Two-Center “Real-World” Experience

Mathias Schreckenberger

Samer Ezziddin

and

Florian Rosar

Cancers 2023, 15(5), 1376; https://doi.org/10.3390/cancers15051376 - 21 Feb 2023

Cited by 1 | Viewed by 659

Abstract

In biochemical recurrence of prostate cancer (BCR), prompt tumor localization guides early treatment, potentially improving patient outcomes. Gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (⁶⁸Ga-PSMA-11 PET/CT) detection rates of lesions suspicious for prostate cancer are well known to rise along with prostate-specific antigen (PSA) concentration. However, published data are limited regarding very low values (≤0.2 ng/mL). We retrospectively analyzed ~7-year “real-world” experience in this setting in a large post-prostatectomy cohort (N = 115) from two academic clinics. Altogether 44 lesions were detected in 29/115 men (25.2%) (median [minimum–maximum] 1 [1–4]/positive scan). The apparent oligometastatic disease was found in nine patients (7.8%) at PSA as low as 0.03 ng/mL. Scan positivity rates were highest when PSA was >0.15 ng/mL, PSA doubling time was ≤12 months, or the Gleason score was ≥7b (in 83 and 107 patients, respectively, with available data); these findings were statistically significant (p ≤ 0.04), except regarding PSA level (p = 0.07). Given the benefits of promptly localizing recurrence, our observations suggest the potential value of ⁶⁸Ga-PSMA-11 PET/CT in the very low PSA BCR setting, especially in cases with more rapid PSA doubling time or with high-risk histology. Full article

(This article belongs to the Special Issue PET Imaging in Prostate Cancer)

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