Prostate cancer (PCa) is the second leading cause of cancer-related death in American men. Positron emission
tomography/computed tomography (PET/CT) with emerging radiopharmaceuticals promises accurate staging of primary
disease, restaging of recurrent disease, detection of metastatic lesions and, ultimately, for predicting the aggressiveness of
disease. Prostate-specific membrane antigen (PSMA) is a well-characterized imaging biomarker of PCa. Because PSMA
levels are directly related to androgen independence, metastasis and progression, PSMA could prove an important target
for the development of new radiopharmaceuticals for PET. Preclinical data for new PSMA-based radiotracers are discussed
and include new 89Zr- and 64Cu-labeled anti-PSMA antibodies and antibody fragments, 64Cu-labeled aptamers, and
11C-, 18F-, 68Ga-, 64Cu-, and 86Y-labeled low molecular weight inhibitors of PSMA. Several of these agents, namely 68Ga-
HBED-CC conjugate 15, 18F-DCFBC 8, and BAY1075553 are particularly promising, each having detected sites of PCa
in initial clinical studies. These early clinical results suggest that PET/CT using PSMA-targeted agents, especially with
compounds of low molecular weight, will make valuable contributions to the management of PCa.
DCFBC, molecular imaging, positron emission tomography, PSMA, radiopharmaceutical.
Russell H. Morgan Department of Radiology and Radiological Science, CRBII, 1550 Orleans Street, Baltimore, MD 21231, USA.