Bouchelouche Kirsten, Choyke Peter L
aDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark bMolecular Imaging Program, Center for Cancer Research, National Cancer Institute (NCI), Bethesda, Maryland, USA.
Curr Opin Oncol. 2016 May;28(3):216-21. doi: 10.1097/CCO.0000000000000277.
Increasing attention is being given to personalized medicine in oncology, where therapies are tailored to the particular characteristics of the individual cancer patient. In recent years, there has been greater focus on prostate-specific membrane antigen (PSMA) in prostate cancer (PCa) as a target for imaging and therapy with radionuclides. This review highlights the recent advancements in PSMA positron emission tomography (PET) in PCa during the past year.
Several reports on PSMA PET/computed tomography (CT) in PCa patients are demonstrating promising results, especially for detection of biochemical recurrence. F-PSMA PET/CT may be superior to Ga-PSMA PET/CT. The detection rate of PSMA PET is influenced by prostate-specific antigen level. PSMA PET/CT may have a higher detection rate than choline PET/CT. Only a few reports have been published on PSMA PET/magnetic resonance imaging (MRI), and this modality remains to be elucidated further.
Molecular imaging with PSMA PET is paving the way for personalized medicine in PCa. However, large prospective clinical studies are needed to further evaluate the role of PSMA PET/CT and PET/MRI in the clinical workflow of PCa. PSMA is an excellent target for imaging and therapy with radionuclides, and the 'image and treat' strategy has the potential to become a milestone in the management of PCa patients.
综述目的：肿瘤学中的个性化医疗正受到越来越多的关注，即根据个体癌症患者的特定特征来定制治疗方案。近年来，前列腺癌（PCa）中前列腺特异性膜抗原（PSMA）作为放射性核素成像和治疗的靶点受到了更多关注。本综述重点介绍了过去一年中PSMA正电子发射断层扫描（PET）在PCa方面的最新进展。
最新发现：多篇关于PCa患者PSMA PET/计算机断层扫描（CT）的报告显示出了有前景的结果，尤其是在检测生化复发方面。F-PSMA PET/CT可能优于Ga-PSMA PET/CT。PSMA PET的检测率受前列腺特异性抗原水平的影响。PSMA PET/CT的检测率可能高于胆碱PET/CT。关于PSMA PET/磁共振成像（MRI）的报告仅有少数几篇发表，这种检查方式仍有待进一步阐明。
总结：PSMA PET分子成像为PCa的个性化医疗铺平了道路。然而，需要开展大规模前瞻性临床研究，以进一步评估PSMA PET/CT和PET/MRI在PCa临床诊疗流程中的作用。PSMA是放射性核素成像和治疗的理想靶点，“成像并治疗”策略有可能成为PCa患者管理中的一个里程碑。
