“Imaging agents for the detection of biochemical recurrent prostate cancer could move beyond computed tomography (CT) and magnetic resonance imaging (MRI) in the near future, with the emergence of prostate-specific membrane antigen (PSMA)-PET, particularly in oligometastatic disease, with a high-detection sensitivity rate, explains Thomas Hope, MD.
“PSMA-PET uses small molecules that bind to PSMA, localizes a prostate cancer tumor, and allows radiologists to image patients after 1 hour to detect small sites of disease. Hope and researchers at the University of California, San Francisco (UCSF) are dedicated to bringing this imaging modality to the FDA for approval with diagnostic data as evidence.”
“In the featured article from the February 2017 issue of the Journal of Nuclear Medicine, researchers document the first-in-human application of a new imaging agent to help find prostate cancer in both early and advanced stages and plan treatment. The study indicates that the new agent — a PET radiotracer — is both safe and effective.
“The new agent is a gallium-68 (Ga-68)-labeled peptide BBN-RGD agent that targets both gastrin-releasing peptide receptor (GRPR) and integrin ?v?3. Dual-receptor targeting provides advantages over single-receptor targeting by allowing tumor contrast when either or both receptor types are expressed, improving binding affinity and increasing the number of effective receptors.”
“The FDA today approved Axumin, an injectable radioactive diagnostic agent used to detect recurrent prostate cancer.
“The agent is indicated for PET imaging in men who have suspected prostate cancer recurrence based on elevated PSA levels following treatment.
“The FDA based its decision on results of two studies that evaluated the safety and efficacy of Axumin (Blue Earth Diagnostics). One study compared 105 Axumin scans to histopathology obtained by prostate biopsy and by biopsies of suspicious imaged lesions in men suspected of having prostate cancer recurrence. In the second study, researchers evaluated 96 Axumin scans with C11 choline scans in patients with a median PSA of 1.44 ng/mL.”
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“For women with the most common type of breast cancer, a new way to analyze magnetic resonance images (MRI) data appears to reliably distinguish between patients who would need only hormonal treatment and those who also need chemotherapy, researchers from Case Western Reserve University report.
“The analysis may provide women diagnosed with estrogen positive-receptor (ER-positive) breast cancer answers far faster than current tests and, due to its expected low cost, open the door to this kind of testing worldwide.
“The research is published in the journal Nature Scientific Reports.”
“A novel molecular imaging technology not only detects prostate cancer that has spread throughout the body, but also provides a potent and minimally invasive method of radiotherapy, reveal researchers at the 2015 Society of Nuclear Medicine and Molecular Imaging annual meeting.
“Each year, SNMMI chooses an image that exemplifies the most promising advances in the field of nuclear medicine and molecular imaging. The state-of-the-art technologies captured in these images demonstrate the capacity to improve patient care by detecting disease, aiding diagnosis, improving clinical confidence and providing a means of selecting appropriate treatments.
“The 2015 SNMMI Image of the Year goes to a team of researchers from the department of nuclear medicine at the University Hospital Heidelberg and the German Cancer Research Center in Heidelberg, Germany. The emerging technology portrays a theranostic drug called PSMA-617, a prostate-specific membrane antigen inhibitor that targets the enzyme on the surface of prostate cancer cells, even if they have spread, or metastasized, to other organs.”
“Where you receive medical care impacts many things — including whether or not you receive inappropriate medical tests, according to a new study.
“Researchers from NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center, in a new retrospective study publishing online March 12th in JAMA Oncology, conclude that patients with low-risk prostate or breast cancer were more or less likely to receive inappropriate imaging during treatment, depending on the region of the country in which they received medical care.
“They examined medical records from 2004-2007 of 9,219 men with low-risk prostate cancer and 30,398 women with low-risk breast cancer, across 84 separate hospital referral regions (HRRs). They conclude that overuse of imaging occurred at a rate of approximately 44.4% for men and nearly 42% for women in the study.
“Equally important, inappropriate use of imaging was strongly linked to certain regions across the U.S. in which patients were treated. For example, HRRs in the Northeast reported higher use of imaging tests for low-risk patients, while other regions, such as the Northwest and Utah, demonstrated more appropriate use of imaging.
“After more than a decade of development and data-gathering—including breast scans on nearly 700 women and 79 patents issued—the U.S. Food and Drug Administration has approved a breast-cancer imaging system invented by a University of Rochester Medical Center professor.
“FDA approval of the breast scanner is the latest in a long line of URMC technologies that have been licensed and marketed, including cancer and pediatric vaccines.
“The professor, Ruola Ning, Ph.D., is president and founder of Koning Corporation, a URMC startup company. The FDA’s action allows Koning to begin commercial distribution of its Koning Breast CT (KBCT) system. Koning’s medical device passed the FDA’s most stringent premarket approval process, which requires extensive clinical study.
“Currently, the KBCT is not intended to be used for breast cancer screening, or to replace mammography. It is for diagnosing cancer in women who have signs or symptoms of the disease, or who have abnormal findings after a standard screening mammogram. For these more complex cases, the KBCT was found to be safe and effective for diagnostic use.”
“A new breast imaging technique pioneered at Mayo Clinic nearly quadruples detection rates of invasive breast cancers in women with dense breast tissue, according to the results of a major study published this week in the American Journal of Roentgenology.
“Molecular Breast Imaging (MBI) is a supplemental imaging technology designed to find tumors that would otherwise be obscured by surrounding dense breast tissue on a mammogram. Tumors and dense breast tissue can both appear white on a mammogram, making tumors indistinguishable from background tissue in women with dense breasts. About half of all screening-aged women have dense breast tissue, according to Deborah Rhodes, M.D., a Mayo Clinic Breast Clinic physician and the senior author of this study.
“MBI increased the detection rate of invasive breast cancers by more than 360 percent when used in addition to regular screening mammography, according to the study. MBI uses small, semiconductor-based gamma cameras to image the breast following injection of a radiotracer that tumors absorb avidly. Unlike conventional breast imaging techniques, such as mammography and ultrasound, MBI exploits the different behavior of tumors relative to background tissue, producing a functional image of the breast that can detect tumors not seen on mammography.”
The gist: A new imaging technique might help doctors more accurately diagnose the severity of prostate cancer. This could help them more effectively choose the right treatment for a patient.
“In 2014, prostate cancer was the leading cause of newly diagnosed cancers in men and the second leading cause of cancer death in men. Writing in the January 6, 2015 issue of the journal Prostate Cancer and Prostatic Disease, a team of scientists and physicians from the University of California, San Diego School of Medicine, with counterparts at University of California, Los Angeles, describe a novel imaging technique that measurably improves upon current prostate imaging – and may have significant implications for how patients with prostate cancer are ultimately treated.
” ‘This new approach is a more reliable imaging technique for localizing tumors. It provides a better target for biopsies, especially for smaller tumors,’ said Rebecca Rakow-Penner, MD, PhD, a research resident in the Department of Radiology and the study’s first author.
“The technique is also valuable in surgical planning and image staging, said David S. Karow, MD, PhD, assistant professor of radiology at UC San Diego and the study’s corresponding author. ‘Doctors at UC San Diego and UCLA now have a non-invasive imaging method to more accurately assess the local extent of the tumor and possibly predict the grade of the tumor, which can help them more precisely and effectively determine appropriate treatment.’ “