Non-Invasive Molecular Imaging and its Impact on Management of the Localized Disease and Suspected Recurrence

Andrei H. Iagaru, MD, FACNM, presented “Non-Invasive Molecular Imaging and its Impact on Management of the Localized Disease and Suspected Recurrence” during the Virtual Global Summit on Precision Diagnosis and Treatment of Prostate Cancer in October 2020.

How to cite: Iagaru, Andrei H. “Non-Invasive Molecular Imaging and its Impact on Management of the Localized Disease and Suspected Recurrence.” October 2020. Accessed Jul 2024. https://grandroundsinurology.com/non-invasive-molecular-imaging-and-its-impact-on-management-of-the-localized-disease-and-suspected-recurrence/

Non-Invasive Molecular Imaging and its Impact on Management of the Localized Disease and Suspected Recurrence – Summary

Andrei H. Iagaru, MD, FACNM, Professor of Radiology and Chief of the Division of Nuclear Medicine and Molecular Imaging at Stanford University, enumerates the applications of a dual radiopharmaceutical-targeted imaging approach using prostate-specific membrane antigen (PSMA) and gastrin-releasing peptide receptor (GRPR) in prostate cancer care. He explains that while PSMA-targeted PET imaging is more widely accepted, GRPR-targeted imaging may identify tumors that PSMA-targeted PET misses and vice versa. Therefore, combining the two can give clinicians a clearer understanding of the patient’s cancer. Dr. Iagaru suggests that the dual target approach can be particularly helpful in guiding biopsy decisions in patients with suspected prostate cancer, as well as in helping identify all lesions prior to local therapy with high-intensity focused ultrasound (HIFU) or brachytherapy. Using two targets can also sometimes allow clinicians to find more lesions prior to prostatectomy and pelvic lymph node dissection. He notes that targeting GRPR with 68Ga-RM2 can be particularly useful in patients with biochemical recurrence, since PSA velocity is higher in 68Ga-RM2 positive scans than in 68Ga-RM2 negative scans. Dr. Iagaru concludes by considering the potential of these two targets in theranostics, noting that phase 3 trials of theranostics with PSMA are awaiting results and that phase 1 and 2 trials of theranostics with GRPR are promising.  

The Virtual Global Summit on Precision Diagnosis and Treatment of Prostate Cancer brings together key international opinion leaders of every clinical subspecialty involved in patient care. This event is an integral part of the AdMeTech Foundation’s Annual Summit, which was established in 2016 and become seminal in shaping the state of the art and future vision for precision care. The goal of this event is three-fold: 1) Educating the key stakeholders; 2) Supporting a sustained cross-disciplinary dialogue and consensus on the best emerging clinical practices and research priorities; and 3) Expediting clinical adoption of promising novel diagnostics and therapeutics. For more educational activities from this virtual event, visit our collection page.