The potential of gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography as a main diagnostic tool in prostate cancer staging

镓-68前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描作为前列腺癌分期主要诊断工具的潜力

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Abstract

INTRODUCTION: Prostate cancer (PC) remains a significant global health burden, necessitating accurate staging for optimal treatment planning. Conventional imaging methods, including multiparametric magnetic resonance imaging (mpMRI), computed tomography (CT), and bone scintigraphy (BS), exhibit limitations in sensitivity and specificity. Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography ((68)Ga PSMA-PET/CT) has emerged as a promising alternative, with potential advantages in staging accuracy. MATERIAL AND METHODS: A comprehensive review of current literature was conducted to assess the role of (68)Ga PSMA-PET/CT in primary PC staging. The diagnostic performance of PSMA-PET/CT was compared with conventional imaging techniques in detecting locoregional and distant metastases. Studies evaluating sensitivity, specificity, and clinical utility in treatment decision-making were analyzed. RESULTS: (68)Ga PSMA-PET/CT demonstrated superior sensitivity and specificity in detecting lymph node and distant metastases compared to conventional imaging. It enables earlier and more precise disease staging, potentially reducing the need for multiple imaging modalities. Emerging evidence suggests its role in guiding therapeutic strategies, particularly in high-risk and recurrent PC cases. Despite its advantages, limitations such as accessibility, cost, and occasional false-negative findings must be considered. CONCLUSIONS: (68)Ga PSMA-PET/CT represents a transformative diagnostic tool for PC staging, offering enhanced accuracy compared to traditional imaging. Its integration into clinical practice could streamline diagnostic pathways, improve treatment selection, and potentially optimize patient outcomes. Further research and cost-effectiveness analyses are needed to establish its widespread implementation.

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