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A Practical Guide for the Production and PET/CT Imaging of 68Ga-DOTATATE for Neuroendocrine Tumors in Daily Clinical Practice
Published on: April 17, 2019
Somatostatin imaging of neuroendocrine-differentiated prostate cancer
Thomas A Hope1, Rahul Aggarwal, Jeff P Simko
1From the *Department of Radiology and Biomedical Imaging, †Division of Hematology/Oncology, Department of Medicine, Departments of ‡Pathology, §Urology, and ∥Radiation Oncology, University of California San Francisco, San Francisco, CA.
Abstract:
After prolonged androgen deprivation therapy, a subset of castrate-resistant prostate cancer patients will develop neuroendocrine prostate cancer (NEPC) associated with resistance to further hormonal therapy and frequent visceral metastases. Imaging the presence of somatostatin receptors on the cancer cell surface may provide a readily available, noninvasive means to distinguish adenocarcinoma from NEPC. This distinction is important for therapeutic decision making and may open the door for developing novel radionuclide targets for the treatment of this aggressive subtype of prostate cancer. We describe a case of NEPC successfully imaged using In-labeled octreotide.
Insights
Neuroendocrine prostate cancer (NEPC) can develop after hormone therapy for prostate cancer. Somatostatin receptor imaging using In-labeled octreotide can help distinguish NEPC from adenocarcinoma, guiding treatment decisions for this aggressive cancer.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiochemistry
Background:
- Neuroendocrine prostate cancer (NEPC) is an aggressive subtype of castrate-resistant prostate cancer (CRPC).
- NEPC often develops after prolonged androgen deprivation therapy (ADT).
- NEPC is associated with resistance to hormonal therapies and frequent visceral metastases.
Observation:
- Somatostatin receptors are often expressed on NEPC cell surfaces.
- Imaging somatostatin receptors offers a potential noninvasive method to differentiate NEPC from prostate adenocarcinoma.
- This distinction is critical for appropriate therapeutic strategies.
Findings:
- A case of NEPC was successfully imaged using Indium-111 labeled octreotide (In-octreotide).
- In-octreotide imaging demonstrated the presence of somatostatin receptors on the NEPC tumor.
- This highlights the utility of somatostatin receptor imaging in identifying NEPC.
Implications:
- Somatostatin receptor imaging can aid in the diagnosis and management of NEPC.
- Noninvasive imaging can guide treatment decisions for patients with advanced prostate cancer.
- This approach may facilitate the development of targeted radionuclide therapies for NEPC.
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