Advances in positron emission tomography applications for urologic cancers

Abstract

Molecular imaging in oncology utilizes advances in imaging technology with probes that image key molecules and molecular based events that are fundamental for malignant change and progression. PET in combination with computed tomography will be the means by which molecular imaging will be translated into the advanced practice of urology. This review introduces the concept of molecular imaging and summarizes current and future molecular imaging approaches that are likely to have a major impact on clinical practice in the near future. In renal cancer, a radiolabeled antibody, iodine-124 cG250, shows promise for improving management of small clear-cell renal cancers through noninvasive immunologic identification as a basis for differential diagnosis of other renal masses. In prostate cancer, antibodies to key antigens, such as prostate specific membrane antigen, along with metabolic probes, for glycolysis (fluorodeoxyglucose) and amino acid transport (C-11 methionine) are likely to improve early detection of regional and distant metastases and provide a basis for improved monitoring of treatment response. Molecular imaging, through PET/computed tomography will help individualize patient care for surgical urology. Applications will include noninvasive image-based immunotyping of human cancers and metabolic based staging, detection and treatment monitoring for urologic malignancies.