New prospects for PET in prostate cancer imaging: a physicist's viewpoint.

Maurizio Conti

doi:10.1186/2197-7364-1-11

Abstract

Prostate cancer is one of the most common forms of cancer among men. Early diagnosis, correct staging, accurate detection of metastasis, and monitoring of the therapy are the key tasks that could greatly benefit from medical imaging. After a review of the main developments in the field of positron emission tomography (PET) tracers for prostate cancer, the impact of improved PET instrumentation with good spatial resolution and high sensitivity is discussed, together with the latest development in PET technology: lutetium oxy-ortho-silicate (LSO) and lutetium-yttrium oxy-ortho-silicate (LYSO) scintillators, resolution recovery, and time-of-flight reconstruction. New directions and multiple approaches in PET instrumentation for prostate cancer are presented and discussed. In particular, improved hardware and noise suppressing reconstruction algorithms allow for higher detectability of small lesions and better spatial resolution in PET/computerized tomography (CT) and PET/magnetic resonance (MR). This can be beneficial for guiding biopsy and surgery and for accurate therapy monitoring.Electronic supplementary materialThe online version of this article (doi:10.1186/2197-7364-1-11) contains supplementary material, which is available to authorized users.

Highlights

Medical imaging techniques are used in prostate cancer (PCa) for diagnosis, staging, detection of local recurrence and metastasis, and therapy monitoring
The increasing availability of a new generation of positron emission tomography (PET) scanners in the clinical environment makes it possible to revisit the limitations of PET
Monitoring adjust therapy have higher sensitivity and improved reconstruction algorithms: both factors contribute to lowering of the noise level and allow for the exploitation of the full spatial resolution of the PET scanner

Summary

Introduction

Medical imaging techniques are used in prostate cancer (PCa) for diagnosis, staging, detection of local recurrence and metastasis, and therapy monitoring. The two lesions, not visible at low resolution, are clearly visible using PSF + TOF and high resolution These images, based on simulations of realistic distributions of prostate cancer PET tracers, hint that it is possible to push the past limits of detectability and localization of small tumors in the pelvic area, if using the present generation of TOF PET scanners. This needs to be confirmed by experimental data. Improved technologies and multimodalities, such as multiparametric MR + PET and dynamic PET, could be useful investigative tools, together with more specific PET tracers, in the search for markers of aggressiveness [64]

Conclusions

Findings

32. Conti M