Islam Raeesa, Desai Shrijal, Moran Melissa, Golombos David M
Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, 285 George St. Apt 906, New Brunswick, NJ, USA.
Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Curr Urol Rep. 2025 May 31;26(1):46. doi: 10.1007/s11934-025-01268-2.
Prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging has revolutionized prostate cancer detection and management. This review aims to evaluate the latest advancements in PSMA PET imaging, assess its clinical applications in various disease stages, and compare it to conventional imaging techniques. We sought to determine how PSMA PET impacts clinical decision-making, treatment strategies, and patient outcomes, with a focus on its expanding role in precision oncology.
Recent studies have demonstrated that PSMA PET exhibits superior sensitivity and specificity in detecting prostate cancer metastases, particularly in cases of biochemical recurrence and early-stage disease. The advent of radiolabeled PSMA ligands, such as 68Ga-PSMA-11 and 18 F-DCFPyL, has led to improved diagnostic accuracy. Furthermore, PSMA-targeted radioligand therapies (e.g., 177Lu-PSMA-617) show promising results in metastatic castration-resistant prostate cancer (mCRPC), offering a novel therapeutic avenue. Studies have also highlighted the role of PSMA PET in refining treatment plans, including guiding surgery and radiotherapy. PSMA PET imaging represents a paradigm shift in prostate cancer diagnostics, staging, and treatment monitoring. It has led to earlier and more accurate detection of metastases, significantly altering management strategies. The growing body of evidence supports its integration into standard-of-care protocols, with ongoing research focusing on optimizing its therapeutic applications. Future studies should explore cost-effectiveness, accessibility, and potential synergies with emerging systemic therapies to further enhance patient outcomes.
前列腺特异性膜抗原(PSMA)靶向正电子发射断层扫描(PET)成像彻底改变了前列腺癌的检测和管理。本综述旨在评估PSMA PET成像的最新进展,评估其在不同疾病阶段的临床应用,并将其与传统成像技术进行比较。我们试图确定PSMA PET如何影响临床决策、治疗策略和患者预后,重点关注其在精准肿瘤学中不断扩大的作用。
最近的研究表明,PSMA PET在检测前列腺癌转移方面表现出卓越的敏感性和特异性,尤其是在生化复发和早期疾病的情况下。放射性标记的PSMA配体(如68Ga-PSMA-11和18F-DCFPyL)的出现提高了诊断准确性。此外,PSMA靶向放射性配体疗法(如177Lu-PSMA-617)在转移性去势抵抗性前列腺癌(mCRPC)中显示出有前景的结果,提供了一种新的治疗途径。研究还强调了PSMA PET在优化治疗计划中的作用,包括指导手术和放疗。PSMA PET成像代表了前列腺癌诊断、分期和治疗监测的范式转变。它已导致更早、更准确地检测转移灶,显著改变了管理策略。越来越多的证据支持将其纳入标准治疗方案,正在进行的研究专注于优化其治疗应用。未来的研究应探索成本效益、可及性以及与新兴全身疗法的潜在协同作用,以进一步改善患者预后。