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Diagnostics
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The Use of PSMA in Nuclear Medicine beyond Prostate Cancer
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The Use of PSMA in Nuclear Medicine beyond Prostate Cancer

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 6138

Special Issue Editors

Dr. Virginia Liberini

E-Mail Website
Guest Editor
Nuclear Medicine Department, S. Croce e Carle Hospital, 12100 Cuneo, Italy
Interests: nuclear medicine; PET imaging; theranostic; radiomics
Dr. Riccardo Laudicella

E-Mail Website
Guest Editor
Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
Interests: PET/CT; PET/MRI; artificial intelligence; theranostic
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent decades, the growing popularity of prostate-specific membrane antigen (PSMA) imaging for prostate cancer has resulted in the incidental discovery of abnormal uptakes associated with the presence of inflammatory, infectious, extra-prostatic neoplastic, and dysmetabolic diseases.

As a result of these incidental findings, an increasing number of immunohistochemistry (IHC) studies and a deeper understanding of the mechanisms of expression of PSMA have been observed in several other normal tissues (such as renal tubules, salivary and lacrimal glands, small and large intestine, astrocytes, liver, spleen, thyroid, and synovial tissue), non-neoplastic conditions (infectious or inflammatory processes of bone-related conditions, benign diseases) and non-prostatic malignancies (salivary gland tumors, thyroid tumors, hepatocarcinoma, renal carcinomas, glioblastoma, breast tumors, lung tumors, gastric carcinoma, osteosarcoma, pancreatic cancer, gynecological malignancies, etc.).

Particularly in the oncology field, data from the literature have demonstrated that PSMA- and FDG-based imaging could play a complementary role in detecting the same phenomenon from multiple perspectives, providing molecular information on cancer biology with important consideration for radioligand therapy (RLT). Indeed, evidence of PSMA expression by a tumor would allow radioligand therapy to be used on the patient; thus, selected patients might benefit from a dual-tracer strategy.

This Special Issue aims to collect further scientific evidence on extra-prostatic tumors and benign pathologies that exhibit PSMA expression and can be studied with PSMA-based positron emission tomography (PET) as an additional or alternative tool to conventional imaging, with the aim of providing an overview of possible future applications of PSMA, both in diagnostic and theranostic settings.

In this Special Issue, we will collect case reports, original articles, and reviews focused on novel insights into PSMA-PET and therapy in oncological and non-oncological fields.

Dr. Virginia Liberini
Dr. Riccardo Laudicella
Guest Editors

Manuscript Submission Information

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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. Diagnostics 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

  • nuclear medicine
  • theranostic
  • PSMA
  • PET
  • cancer

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Published Papers (4 papers)

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Research

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12 pages, 2155 KiB  
Article
Dependence of Renal Uptake on Kidney Function in [68Ga]Ga-PSMA-11 PET/CT Imaging
by Falk Gühne, Till Schilder, Philipp Seifert, Christian Kühnel and Martin Freesmeyer
Diagnostics 2024, 14(7), 696; https://doi.org/10.3390/diagnostics14070696 - 26 Mar 2024
Viewed by 1383
Abstract
(1) Background: PSMA ligand PET/CT is increasingly important for diagnostics of prostate cancer and other tumor diseases. In particular, the radiopharmaceutical [68Ga]Ga-PSMA-11 is widely used. Besides its tumor-specific binding, the uptake within the kidneys is dominant and seems to visualize the [...] Read more.
(1) Background: PSMA ligand PET/CT is increasingly important for diagnostics of prostate cancer and other tumor diseases. In particular, the radiopharmaceutical [68Ga]Ga-PSMA-11 is widely used. Besides its tumor-specific binding, the uptake within the kidneys is dominant and seems to visualize the renal cortex specifically. Kidney diseases may alter the uptake of radiopharmaceuticals. Therefore, the correlation between renal uptake in PET/CT imaging and renal function should be investigated. (2) Methods: A group of 103 male patients were retrospectively evaluated for eGFR according to the CKD-EPI equation, tracer uptake intensity (SUVmax, SUVpeak, SUVmean), the molecular volume of the renal cortex, morphological kidney size, and total renal uptake. Manual and three different computer-assisted contouring methods (thresholds at 50% of SUVmax, 30% of SUVmax, and absolute SUV of 20) were used for measurements. Correlations between parameters were calculated using linear regression models. (3) Results: Renal SUVmax, SUVpeak, and SUVmean do not correlate with eGFR for manual or computer-assisted measurements. In contrast, molecular cortex volume shows a moderate correlation with eGFR (R2 = 0.231, p < 0.001), superior to morphological kidney size. A contouring threshold of 30% of SUVmax outperformed the other settings for renal cortex volume and total renal uptake. (4) Conclusions: Renal uptake of [68Ga]Ga-PSMA-11 cannot predict eGFR, but the functional renal cortex can be quantified by PET/CT imaging. Full article
(This article belongs to the Special Issue The Use of PSMA in Nuclear Medicine beyond Prostate Cancer)
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Review

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18 pages, 1127 KiB  
Review
Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals
by Alberto Miceli, Virginia Liberini, Giovanna Pepe, Francesco Dondi, Antonio Vento, Lorenzo Jonghi Lavarini, Greta Celesti, Maria Gazzilli, Francesca Serani, Priscilla Guglielmo, Ambra Buschiazzo, Rossella Filice, Pierpaolo Alongi, Riccardo Laudicella and Giulia Santo
Diagnostics 2024, 14(10), 1002; https://doi.org/10.3390/diagnostics14101002 - 13 May 2024
Cited by 1 | Viewed by 1821
Abstract
Background: Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein overexpressed on the surface of tumor cells in most of the patients affected by prostate adenocarcinoma (PCa). However, PSMA expression has also been demonstrated in the endothelial cells of newly formed vessels [...] Read more.
Background: Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein overexpressed on the surface of tumor cells in most of the patients affected by prostate adenocarcinoma (PCa). However, PSMA expression has also been demonstrated in the endothelial cells of newly formed vessels of various solid tumors, suggesting a role for PSMA in neoangiogenesis. In this scenario, gallium-68 (68Ga) or fluoro-18 (18F)-labeled PSMA positron emission tomography (PET) may play a role in tumors other than PCa, generally evaluated employing other radiopharmaceuticals targeting different pathways. This review aims to investigate the detection rate of PSMA-PET compared to other radiopharmaceuticals (especially [18F]FDG) in non-prostate tumors to identify patients who may benefit from the use of such a theragnostic agent. Methods: We performed a bibliographic search on three different databases until February 2024 using the following terms: “positron emission tomography”, “PET”, “PET/CT”, “Prostate-specific membrane antigen”, “PSMA”, “non-prostate”, “not prostate cancer”, “solid tumor”, “FDG”, “Fluorodeoxyglucose”, “FAPi”, “FET”, “MET”, “DOPA”, “choline”, “FCH”, “FES”, “DOTATOC”, “DOTANOC”, and “DOTATATE”. Only original articles edited in English with at least 10 patients were included. Results: Out of a total of 120 articles, only 25 original articles comparing PSMA with other radiotracers were included in this study. The main evidence was demonstrated in renal cell carcinoma, where PSMA showed a higher detection rate compared to [18F]FDG PET/CT, with implications for patient management. PSMA PET may also improve the assessment of other entities, such as gliomas, in defining regions of early neoangiogenesis. Further data are needed to evaluate the potential role of PSMA-PET in triple-negative breast cancer as a novel therapeutic vascular target. Finally, unclear applications of PSMA-PET include thyroid and gastrointestinal tumors. Conclusions: The present review shows the potential use of PSMA-labeled PET/CT in solid tumors beyond PCa, underlining its value over other radiopharmaceuticals (mainly [18F]FDG). Prospective clinical trials with larger sample sizes are crucial to further investigate these possible clinical applications. Full article
(This article belongs to the Special Issue The Use of PSMA in Nuclear Medicine beyond Prostate Cancer)
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Other

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13 pages, 876 KiB  
Systematic Review
The Potential Role of PSMA-Targeted PET in Salivary Gland Malignancies: An Updated Systematic Review
by Alessio Rizzo, Domenico Albano, Federica Elisei, Manuela Racca, Francesco Dondi, Salvatore Annunziata, Marco Cuzzocrea, Francesco Bertagna and Giorgio Treglia
Diagnostics 2024, 14(14), 1516; https://doi.org/10.3390/diagnostics14141516 - 14 Jul 2024
Viewed by 1239
Abstract
Background: Recent studies have suggested using positron emission tomography/computed tomography (PET/CT) with prostate-specific membrane antigen (PSMA)-targeting radiopharmaceuticals for the detection of salivary gland malignancies (SGM), particularly adenoid-cystic carcinoma (ACC). Methods: The authors conducted an extensive review of the scientific literature to examine the [...] Read more.
Background: Recent studies have suggested using positron emission tomography/computed tomography (PET/CT) with prostate-specific membrane antigen (PSMA)-targeting radiopharmaceuticals for the detection of salivary gland malignancies (SGM), particularly adenoid-cystic carcinoma (ACC). Methods: The authors conducted an extensive review of the scientific literature to examine the potential diagnostic role of PET/CT using PSMA-targeting radiopharmaceuticals in salivary gland malignancies (SGMs) and adenoid cystic carcinoma (ACC). This study included newly diagnosed SGM patients and those with disease recurrence in their imaging evaluation. Results: This updated systematic review included a total of six studies that examined the diagnostic performance of PSMA-targeted PET/CT in ACC. The articles provided evidence of a high detection rate of PSMA-targeting PET/CT in ACC across all clinical contexts examined. SGMs other than ACC exhibited poorer diagnostic performance. Conclusions: PSMA-targeted PET/CT seems promising in detecting ACC lesions; moreover, PSMA appears to be a suitable potential target for radioligand therapy. Prospective multicentric studies are warranted to strengthen the role of PSMA-targeting radiopharmaceuticals in ACC, as both diagnostic and theragnostic agents. Full article
(This article belongs to the Special Issue The Use of PSMA in Nuclear Medicine beyond Prostate Cancer)
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3 pages, 910 KiB  
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68Ga-DOTATATE and 68Ga-Pentixafor PET/CT in a Patient with Castleman Disease of the Retroperitoneum
by Rui Zuo, Lu Xu and Hua Pang
Diagnostics 2024, 14(4), 372; https://doi.org/10.3390/diagnostics14040372 - 8 Feb 2024
Cited by 1 | Viewed by 1044
Abstract
This is a case of a 42-year-old man with recurrent symptoms of dizziness and a newly found retroperitoneal mass with no 131I-MIBG uptake who was referred for restaging with 68Ga-DOTATATE PET/CT and local 68Ga-pentixafor PET/CT. The examinations both showed intense [...] Read more.
This is a case of a 42-year-old man with recurrent symptoms of dizziness and a newly found retroperitoneal mass with no 131I-MIBG uptake who was referred for restaging with 68Ga-DOTATATE PET/CT and local 68Ga-pentixafor PET/CT. The examinations both showed intense radioactivity uptake in the retroperitoneal mass and no abnormal uptake in the right adrenal nodule. Two lesions showed distinct properties of radioactivity uptake, which suggested the possibility of different sources. A postoperative pathological test revealed that the morphology and immunohistochemistry of the retroperitoneal mass was found to be consistent with Castleman disease, and the right adrenal gland was normal tissue. Full article
(This article belongs to the Special Issue The Use of PSMA in Nuclear Medicine beyond Prostate Cancer)
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