PET imaging for lymph node dissection in prostate cancer

The detection of neoplastic lymph nodal involvement in prostate cancer (PCa) patients has relevant therapeutic and prognostic significance, both in the clinical settings of primary staging and restaging. Lymph nodal dissection (LND) currently represents the gold standard for evaluating the presence of lymph nodal involvement. However, this procedure is invasive, associated with morbidity, and may fail in detecting all potential lymph nodal metastatic regions. Currently the criteria for lymph nodal detection using conventional imaging techniques mainly rely on morphological assessment with unsatisfactory diagnostic accuracy. Positron emission tomography (PET) represents a helpful imaging technique for a proper staging of lymph nodal status. The most investigated PET radiotracer is choline, although many others have been explored as guide for both primary and salvage LND, such as fluorodeoxyglucose, acetate, fluorocyclobutanecarboxylic acid and prostate-specific membrane antigen. In the present review, a comprehensive literature review addressing the role of PET for LND in PCa patients is reported, with the use of the above-mentioned radiotracers.

World journal of urology. 2016 Oct 17 [Epub ahead of print]

Elena Incerti, Paola Mapelli, Luigi Gianolli, Maria Picchio

Unit of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Unit of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. .