In addition to these advantages, PET/MRI is superior to PET/CT for soft tissue or lymph node lesions. However, CT has the benefits of being faster, improved bone evaluation, and is about 25% of the cost.
64Cu-ATSM PET/MRI was initially developed to image hypoxia, where the agent was trapped in hypoxic cells. This demonstrated efficiency in predicting outcomes in several solid tumors including cancers of the head and neck, lung, rectum and cervix. 64Cu-ATSM uptake has been correlated with MRI features of clinically significant disease on both T2 and diffusion weighted MR imaging. Additionally, the potential benefit of less transitional zone but more seminal vesical, bladder (but not lumenal), or nodal uptake has been noted. ATSM signal uniformity compared to mpMRI has been seen in areas of extracapsular extension.
The expanding selection of prostate cancer radiotracer pharmaceuticals may be overwhelming, but selecting the optimal tracer may have potential benefit for evaluation of tumor burden with treatment implications.
Presented by: Joseph Ippolito, MD, PhD, Washington University School of Medicine in St. Louis
Written by: David B. Cahn, DO, MBS, @dbcahn, Fox Chase Cancer Center, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC