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A Review of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) in Renal Cell Carcinoma (RCC)

  • Thomas Ahn
  • Matthew J. Roberts
  • Aous Abduljabar
  • Andre Joshi
  • Marlon Perera
  • Handoo Rhee
  • Simon Wood
  • Ian Vela
Review Article
  • 69 Downloads

Abstract

Metastatic renal cell carcinoma (mRCC) is a disease that portends poor prognosis despite an increasing number of novel systemic treatment options including new targeted therapies and immunotherapy. Ablative intervention directed at oligometastatic RCC has demonstrated survival benefit. Consequently, developing techniques for improved staging of mRCC on contemporary imaging modalities including X-ray computed tomography (CT), magnetic resonance imaging (MRI) and/or bone scan (BS) is a clinical priority. This is relevant for metastatic deposits too small to characterize or lymph nodes within physiological normality. Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein highly expressed on prostate cancer epithelial cells. Recently, small molecules targeting the PSMA receptor, linked to radioactive isotopes have been developed for use with positron emission tomography (PET). Despite its nomenclature, PSMA has also been found to be expressed in the neovasculature of non-prostate cancers such as renal cell carcinoma (RCC) and hence PSMA PET/CT imaging has been proposed as an alternative staging modality. Preliminary small studies involving the use of PSMA PET/CT imaging in mRCC have been encouraging with evidence of improved staging sensitivity which has directly led to change in management in some cases. Given these early encouraging reports, we performed a comprehensive narrative review on the available evidence, including the scientific basis for PSMA expression in RCC, the role of PSMA PET/CT imaging with potential clinical implications in mRCC, its limitations and future opportunities.

Key words

Positron emission tomography Prostate-specific membrane antigen Gallium Renal cell carcinoma Metastasis 

Notes

Funding Information.

This research received no specific grant from any funding agency in public, commercial, or not-for-profit sectors. IV is supported by a Movember Clinician Scientist Award awarded through Prostate Cancer Foundation of Australia’s Research Program.

Compliance with Ethical Standards

Conflict of Interest

All authors declare that there is no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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© World Molecular Imaging Society 2019

Authors and Affiliations

  1. 1.Department of UrologyGreenslopes Private HospitalBrisbaneAustralia
  2. 2.Faculty of MedicineThe University of QueenslandBrisbaneAustralia
  3. 3.Department of UrologyPrincess Alexandra HospitalBrisbaneAustralia
  4. 4.Department of UrologyTownsville HospitalBrisbaneAustralia
  5. 5.Centre for Clinical ResearchThe University of QueenslandBrisbaneAustralia
  6. 6.Centre for Kidney Disease ResearchTranslational Research InstituteBrisbaneAustralia
  7. 7.Department of Surgery, Austin HealthThe University of MelbourneParkvilleAustralia
  8. 8.Australian Prostate Cancer Research Center Queensland, Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneAustralia

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