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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) The role of PSMA radioligands in the diagnosis and treatment of prostate carcino...
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Vol. 41. Issue 2.
Pages 126-135 (March - April 2022)
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Vol. 41. Issue 2.
Pages 126-135 (March - April 2022)
Continuing Education
The role of PSMA radioligands in the diagnosis and treatment of prostate carcinoma
Utilidad de los radioligandos PSMA en el diagnóstico y tratamiento del carcinoma de próstata
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M. Rodríguez-Frailea,
Corresponding author
mrodriguez@unav.es

Corresponding author.
, P. Tamayo Alonsob, J.J. Rosalesa, María de Arcocha-Torresc, A.P. Caresia-Arózteguid, María Puig Cózar-Santiagoe, Javier Orcajo-Rinconf, Marc Simó Perdigóg, R.C. Delgado Boltonh, C. Artigas Guixi, on behalf of the Oncology Working Group of the Spanish Society of Nuclear Medicine and Molecular Imaging
a Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Spain
b Servicio de Medicina Nuclear, Hospital Universitario de Salamanca, Salamanca, Spain
c Unidad de Radiofarmacia, Hospital Universitario Marqués de Valdecilla, Santander, Spain
d Servicio de Medicina Nuclear, Parc Taulí Hospital Universitari, Barcelona, Spain
e Servicio de Medicina Nuclear, ERESA – Hospital General Universitario, Valencia, Spain
f Servicio de Medicina Nuclear, Hosp. G.U Gregorio Marañon, Madrid, Spain
g Servicio de Medicina Nuclear Hospital Vall d’Hebron, Barcelona, Spain
h Servicio de Medicina Nuclear, Hospital San Pedro – Centro de Investigación Biomédica de La Rioja (CIBIR), La Rioja, Spain
i Servicio de Medicina Nuclear, Institut Jules Bordet, Université Libre de Bruxelles, Bruselas, Belgium
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Tables (3)
Table 1. TNM staging of the American Joint Committee on Cancer for prostate cancer.
Table 2. Risk groups of recurrence following intention to cure treatment according to the European Association of Urology8.
Table 3. Prostate-specific membrane antigen radiopharmaceutical ligands labeled with [18F].
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Abstract

Prostate cancer (PC) is the most common tumor in men in the West and the fifth leading cause of cancer-related death. The use of PSMA radioligands has represented an important advance both in its diagnosis, through PET molecular imaging, and in its treatment in advanced stages of the disease. This article reviews the contribution of PET studies with PSMA radioligands in initial staging, in tumor detection in biochemical recurrence (elevation of PSA) after treatment with curative intent, and in the more advanced stages of the disease (castration resistant PC or CRPC). The contribution of PSMA radioligand therapy (PSMA-RLT) in CRPC patients who progress to standard therapy is also analyzed.

Keywords:
Prostate cancer
PSMA
PET
PSMA-RLT
Theragnosis
Resumen

El cáncer de próstata (CP) es el tumor más frecuente en varones en Occidente y la quinta causa de muerte relacionada con el cáncer. El uso de radioligandos antígeno prostático específico de membrana (PSMA) ha supuesto un importante avance tanto en su diagnóstico, a través de la imagen molecular de tomografía por emisión de positrones (PET), como en su tratamiento en fases avanzadas de la enfermedad. En este artículo, se hace una revisión de la aportación de los estudios PET con radioligandos PSMA en la estadificación inicial, en la detección tumoral en la recidiva bioquímica (elevación del antígeno prostático específico [PSA]) tras un tratamiento con intención curativa, y en los estadios más avanzados de la enfermedad (CP resistente a la castración o CPRC). Se analiza, además, la aportación de la terapia con radioligandos PSMA (PSMA-TRL) en pacientes con CPRC que progresan a la terapia estándar.

Palabras clave:
Cáncer de próstata
PSMA
PET
PSMA-TRL
Teragnosis

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