Page 20 - ARNM-2-4

Advances in Radiotherapy &

Nuclear Medicine

REVIEW ARTICLE
68 Ga-PSMA PET CT/MRI in the initial diagnosis

and staging of prostate cancer: A review

Oluwatobi I. Akinmuleya 1,2 , Philip F. Cohen , and Kalevi Kairemo *
4,5
3
1 Department of Medicine, Faculty of Medicine, Shenyang Medical College, Liaoning, Shenyang, China
2 Department of Medicine, Greater Accra Regional Hospital, Ghana
3 Department of Nuclear Medicine, Lions Gate Hospital, North Vancouver, Canada
4 Department of Theranostics, Docrates Cancer Center, Helsinki, Finland
5 Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston,
Texas, United States of America

Abstract

Prostate-specific membrane antigen-positron emission tomography (PSMA-PET)
imaging has demonstrated potential in addressing prostate cancer (PCa) diagnostic
difficulties. According to current guidelines, gallium-68 ( Ga)-PSMA-PET is used
68
as an adjunct to traditional imaging modalities in patients with primary PCa. The
purpose of this review, conducted using Preferred Reporting Items for Systematic
Review and Meta-Analysis (PRISMA) guidelines, is to give an overview of studies that
have examined the role of Ga-PSMA in the initial diagnosis of PCa, its performance
68
*Corresponding author: in TNM staging, its correlation with prostate-specific antigen (PSA) levels, targeted
Kalevi Kairemo
(kalevi.kairemo@gmail.com) biopsies, and the International Society of Urological Pathology (ISUP) scores using
computed tomography (CT) or magnetic resonance imaging (MRI). The findings
Citation: Akinmuleya OI, Cohen demonstrate that, in addition to MRI alone, combining Ga-PSMA-PET with MRI-
68
PF, and Kairemo K. Ga-PSMA
68
PET CT/MRI in the initial diagnosis targeted biopsy improves the initial identification of clinically significant prostate
and staging of prostate cancer: A cancer (csPCa), particularly for ambiguous prostate imaging-reporting and data
review. Adv Radiother Nucl Med. 68
2024;2(4):4590. system (PI-RADS) three lesions. Ga-PSMA-PET/CT is useful when MRI results
doi: 10.36922/arnm.4590 for csPCa are uncertain, but consistent techniques are required. Regarding risk
assessment and therapy planning, Ga-PSMA-PET has a strong correlation with
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Received: August 20, 2024
both PSA levels and ISUP scores. It accurately detects primary PCa lesions, making
Accepted: September 23, 2024 it suitable for high-risk patients. In Ga-PSMA-PET, higher maximum standardized
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Published Online: December 16, uptake value (SUV max) readings are linked to more aggressive illness. For N and
2024 M staging, Ga-PSMA-PET/CT is more sensitive and specific than conventional
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Copyright: © 2024 Author(s). imaging; however, for T-staging, multiparametric MRI (mpMRI) provides better
This is an Open-Access article accuracy. Ga-PSMA-PET/MRI shows improved accuracy for primary PCa detection
68
distributed under the terms of the
Creative Commons Attribution compared to mpMRI alone. Challenges include the lack of standardized SUV max
68
License, permitting distribution, cutoff values. Ga-PSMA-PET is useful for the initial diagnosis and staging of PCa,
and reproduction in any medium, complementing MRI, although further research is needed to standardize imaging
provided the original work is
properly cited. techniques and interpretations.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Prostate cancer; PSMA; Radionuclide; PET/CT; PET/MRI; Primary diagnosis;
regard to jurisdictional claims in
published maps and institutional Clinically significant cancer
affiliations

Volume 2 Issue 4 (2024) 1 doi: 10.36922/arnm.4590