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Molecular Imaging of Urogenital Diseases

Seminars in Nuclear Medicine
Elsevier - WB Saunders
DOI: 10.1053/j.semnuclmed.2013.10.008
  • Medicine


There is an expanding and exciting repertoire of PET imaging radiotracers for urogenital diseases, particularly in prostate cancer, renal cell cancer, and renal function. Prostate cancer is the most commonly diagnosed cancer in men. With growing therapeutic options for the treatment of metastatic and advanced prostate cancer, improved functional imaging of prostate cancer beyond the limitations of conventional CT and bone scan is becoming increasingly important for both clinical management and drug development. PET radiotracers, apart from 18F-FDG, for prostate cancer are 18F-sodium fluoride, 11C-choline, and 18F-fluorocholine, and 11C-acetate. Other emerging and promising PET radiotracers include a synthetic l-leucine amino acid analogue (anti–18F-fluorocyclobutane-1-carboxylic acid), dihydrotestosterone analogue (18F-fluoro-5α-dihydrotestosterone), and prostate-specific membrane antigen–based PET radiotracers (eg, N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine, 89Zr-DFO-J591, and 68Ga [HBED-CC]). Larger prospective and comparison trials of these PET radiotracers are needed to establish the role of PET/CT in prostate cancer. Although renal cell cancer imaging with FDG-PET/CT is available, it can be limited, especially for detection of the primary tumor. Improved renal cell cancer detection with carbonic anhydrase IX (CAIX)-based antibody (124I-girentuximab) and radioimmunotherapy targeting with 177Lu-cG250 appear promising. Evaluation of renal injury by imaging renal perfusion and function with novel PET radiotracers include p-18F-fluorohippurate, hippurate m-cyano-p-18F-fluorohippurate, and rubidium-82 chloride (typically used for myocardial perfusion imaging). Renal receptor imaging of the renal renin-angiotensin system with a variety of selective PET radioligands is also becoming available for clinical translation.

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