The evolution of PET imaging in renal, bladder, upper urinary tract urothelial, testicular and penile carcinoma - Today's impact, tomorrow's potential.

The advancement of hybrid PET/CT or PET/MRI imaging for non-prostate genitourinary cancers has not experienced the rapid progress of prostate cancer. Nevertheless, these neoplasms are aggressive and reliable imaging plays a pivotal role in enhancing patients' quality of life and prognosis.

the main evidence regarding [18F]FDG and non-[18F]FDG PET/CT or PET/MRI in non-prostate uro-oncological malignancies are summarized and discussed. Moreover, potential future directions concerning PET imaging in these neoplasms are debated, with the aim to stimulate future research projects covering these fields.

In Renal Cell Carcinoma (RCC), [18F]FDG PET/CT demonstrates varying efficacy in staging, restaging, and prognostic stratification, but PSMA PET/CT is emerging as a potential game-changer, particularly in advanced, high-grade aggressive clear cell RCC. [18F]FDG PET/CT may see an increased use in N and M-staging of bladder cancer, as well as for detecting recurrence and response to neoadjuvant chemotherapy. Preliminary data regarding [68Ga]-FAPI also looks promising in this context. [18F]FDG PET/MRI could be useful for the T-staging of bladder cancer, while upper tract urothelial carcinoma still lacks of molecular imaging literature reports. In testicular and penile cancer [18F]FDG PET/CT has demonstrated its usefulness in several clinical settings, although experiences with non-[18F]FDG radiotracers are lacking.

Expert review of medical devices. 2023 Dec 10 [Epub ahead of print]

Luca Urso, Matteo Bauckneht, Domenico Albano, Sotirios Chondrogiannis, Gaia Grassetto, Francesco Lanfranchi, Francesco Dondi, Giuseppe Fornarini, Massimo Lazzeri, Laura Evangelista

Department of Nuclear Medicine - PET/CT Center, S. Maria Della Misericordia Hospital, Rovigo, Italy., Nuclear Medicine Unit, IRCCS Ospedale Policlinico, San Martino, Genova, Italy., Nuclear Medicine Department, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy., Medical Oncology Unit 1, IRCCS Ospedale Policlinico, San Martino, Genova, Italy., Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy., Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.