Imaging - October 2019

This month we’re talking about” “imaging for prostate cancer.” “Imaging technology is advancing” “rapidly and is transforming” “both prostate cancer diagnosis” “and offering new insight into” “how prostate cancer spreads” “throughout the body. Less clear,” “of course, is how these new” “advances will impact treatment.”

“Dr. Ammar Chaudry of City of” “Hope gives us a good overview” “of the kinds of imaging techniques” “men are likely to encounter during” “their prostate cancer journey.”

“Dr. Oliver Sartor breaks down” “for us the five different types” “of PET scans available today—” “how they work, when they’re” “used, the kinds of information” “they provide, and how their” “results impact treatment.”

“Dr. Thomas Hope offers an in-depth” “analysis of the newest advances” “in imaging, including PSMA” “targeted imaging compounds,” “C-11 Choline, and C-11 ACETATE.” “He also updates on the progress” “of UCSF’s application to the” “FDA for the 68Ga-PSMA-11 scan.” “If that application is approved, in” “about June 2020, the scan will be” “available for you at both UCSF and” “UCLA. That application is unique” “in the sense that UCSF did not” “make it proprietary—which means,” “ultimately, that the 68Ga-PSMA-11” “scan may well become readily” “available to many of you in” “a few short years.”

“There are several issues ways” “that improved imaging might” “improve the management of” “prostate cancer. First, the standard” “imaging techniques used to stage” “prostate cancer, the bone scan” “and CT scan, are well known” “to miss bone and lymph node” “metastases in many patients.” “This is part of the reason so” “many patients progress after” “initial treatment with surgery” “orradiation. Improved imaging” “techniques are likely to do a better” “job detecting metastases that are” “currently missed by bone scan and” “CT scan. This would allow patients” “with early metastatic disease to” “receive more effective treatment” “than local therapy solely directed” “at the prostate gland.” “Second, improved imaging” “techniques are important to” “the rapidly evolving treatment” “of oligometastatic disease.” “This approach is based on the” “concept that there are patients” “who have a limited number” “of cancer metastases and that” “treatment of these metastatic” “deposits with radiation might slow” “cancer progression or even induce” “a durable remission. The better” “we are able to detect the true” “extent of the metastatic disease,” “the more effectively the cancer” “can be targeted.”

Charles E. Myers, Jr., MD

Link to October's Issue