Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer: An Update on Important Pitfalls

Sara Sheikhbahaei; Rudolf A Werner; Lilja B Solnes; Kenneth J Pienta; Martin G Pomper; Michael A Gorin; Steven P Rowe

doi:10.1053/j.semnuclmed.2019.02.006

Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer: An Update on Important Pitfalls

Semin Nucl Med. 2019 Jul;49(4):255-270. doi: 10.1053/j.semnuclmed.2019.02.006. Epub 2019 Mar 4.

Authors

Sara Sheikhbahaei¹, Rudolf A Werner², Lilja B Solnes¹, Kenneth J Pienta³, Martin G Pomper⁴, Michael A Gorin⁴, Steven P Rowe⁵

Affiliations

¹ The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.
² Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
³ The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.
⁴ The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD; The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.
⁵ The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD; The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: srowe8@jhmi.edu.

PMID: 31227049
DOI: 10.1053/j.semnuclmed.2019.02.006

Abstract

The continuing adoption of prostate specific membrane antigen (PSMA)-targeted PET for prostate cancer molecular imaging requires imagers and clinicians alike to be aware of the increasing number of potential interpretive pitfalls that have been reported. This review summarizes and illustrates the spectrum of benign and malignant nonprostatic conditions with high PSMA-radiotracer uptake that may be mistaken for sites of prostate cancer and also discusses potential false negatives. We discuss the recent literature on the effect of androgen deprivation therapy on lesion detection. Furthermore, we briefly review the recently proposed structured reporting systems for the standardized interpretation of PSMA-targeted PET that can guide both imaging specialists and referring clinicians in the appropriate interpretation and work-up of pitfalls.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Androgen Antagonists / therapeutic use
Antigens, Surface / metabolism*
Gene Expression Regulation, Neoplastic
Glutamate Carboxypeptidase II / metabolism*
Humans
Male
Positron-Emission Tomography / methods*
Prostatic Neoplasms / diagnostic imaging*
Prostatic Neoplasms / drug therapy
Prostatic Neoplasms / metabolism*

Substances

Androgen Antagonists
Antigens, Surface
FOLH1 protein, human
Glutamate Carboxypeptidase II