Positron emission tomography in prostate and renal cell carcinoma

Purpose of review: The present review addresses technical improvements in [¹⁸F]deoxyglucose positron emission tomography (PET) and new tracer developments that may increase detection in prostate cancer and renal cell carcinoma. In addition, we discuss the future of molecular imaging in prostate cancer. Recent findings: PET has proven useful in imaging primary and metastatic cancer in a variety of tumor types. Previous work suggested that the most common radiopharmaceutical used in PET imaging -[¹⁸F]deoxyglucose - has a limited role in diagnosing primary prostate cancer and renal cell carcinoma. Technical improvements in scanning techniques and in PET scanners have increased detection of primary and metastatic lesions in both tumor types with [¹⁸F]deoxyglucose PET, as compared with previous studies. These improvements include increased scanner resolution and improved processing algorithms. In both prostate and renal cell carcinoma, however, better detection may result from the development of new tracers, particularly those that are not excreted into renal collecting systems. Labeled choline shows promise, as does [¹¹C]acetate. New tracers for prostate cancer could be developed to detect changes that signal malignant transformation, as well as tracers that could show expression of genes administered for therapy. Summary: Technical improvements and the development of new tracers will probably make PET imaging a viable diagnostic tool in prostate cancer and renal cell carcinoma.