Prostate-specific membrane antigen-guided salvage lymph node dissection in recurrent prostate cancer: A novel technology to detect lymph node metastases

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

Purpose of review With 68 Gallium (68 Ga)-prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) as emerging imaging technique offering superior detection rates in biochemical recurrent prostate cancer, salvage lymph node dissection has gained increasing interest in localized oligometastatic prostate cancer. Currently, PSMA-targeting small molecules cannot only be linked to positron-emitting isotopes for imaging but also be labelled with γ-radiation emitting isotopes. These modified PSMA agents are evaluated for intraoperative guidance for resection of metastatic lymph nodes. This review aims to review current knowledge on the novel technique of PSMA-radioguided surgery. Recent findings Recently radiolabeling of PSMA ligands with 111 Indium and 99m Technetium as γ emitter has been established. After preoperative intravenous injection of these novel PSMA agents single photon emission computed tomography/CT imaging can be performed using the γ-emitting properties. Although its diagnostic performance seems to be inferior to 68 Ga-PSMA PET/CT, intraoperative guidance by the use of a γ probe was reported to facilitate detection and resection of tumour-infiltrated soft tissue. First follow-up data suggests favourable outcomes concerning prostate-specific antigen progression and treatment-free survival in a subset of patients. Summary Although current knowledge is still limited and published data is sparse salvage surgery in recurrent prostate cancer facilitated by γ-emitting PSMA agents seems feasible. However, careful identification of ideal candidates for those procedures is mandatory.

Original languageEnglish
Pages (from-to)191-196
Number of pages6
JournalCurrent Opinion in Urology
Volume28
Issue number2
DOIs
StatePublished - 1 Mar 2018
Externally publishedYes

Keywords

  • biochemical
  • oligometastatic
  • prostate-specific antigen
  • radioguided
  • salvage

Fingerprint

Dive into the research topics of 'Prostate-specific membrane antigen-guided salvage lymph node dissection in recurrent prostate cancer: A novel technology to detect lymph node metastases'. Together they form a unique fingerprint.

Cite this