The Evolving Role of 18F-FDG PET/CT in Diagnosis and Prognosis Prediction in Progressive Prostate Cancer
Kai Shen, Bo Liu, Xiang Zhou, Yiyi Ji, Lei Chen, Qi Wang, Wei Xue
Abstract
Positron emission tomography/computed tomography (PET/CT) is widely used in prostate cancer to evaluate the localized tumor burden and detect symptomatic metastatic lesions early. 18 F-FDG is the most used tracer for oncologic imaging, but it has limitations in detecting early-stage prostate cancer. 68 Ga-PSMA is a new tracer that has high specificity and sensibility in detecting local and metastatic tumors. But with the progression of prostate cancer, the enhancement of glucose metabolism in progressive prostate cancer provides a chance for 18 F-FDG. This review focuses on PET/CT in the detection and prognosis of prostate cancer, summarizing the literature on 18 F-FDG and 68 Ga-PSMA in prostate cancer and highlighting that 18 F-FDG has advantages in detecting local recurrence, visceral and lymph node metastases compared to 68 Ga-PSMA in partial progressive prostate cancer and castration-resistant prostate cancer patients. We emphasize 18 F-FDG PET/CT can compensate for the weakness of 68 Ga-PSMA PET/CT in progressive prostate cancer.