Axumin Pet Scans in Prostate Cancer: What Is It and How Does It Work?

Introduction

Prostate cancer is one of the most common cancers in incidence and cancer-related death. One-third of patients have recurrence following definitive therapy, determined by an increasing PSA (prostate-specific antigen) level. Planning for subsequent management requires an accurate description of the recurrence. The degree of recurrence may be determined using various imaging methods, each with its benefits and drawbacks. The Food and Drug Administration (FDA) has authorized a new PET (positron emission tomography) tracer that uses 18F-Fluciclovine to investigate prostate cancer biochemical recurrence.

What Is an Axumin PET Scan for Prostate Cancer?

Axumin PET scan is a positron emission tomography (PET) imaging technique that locates prostate cancer cells in the body using a radiotracer called Fluciclovine (18F). Since prostate cancer cells can absorb the synthetic amino acid Fluciclovine, it can be used to identify prostate cancer that has returned after initial therapy or migrated to other body regions. The radiotracer is injected into the patient during the operation, and the radioactive emissions from the tracer are subsequently detected using a PET scanner. The generated pictures offer comprehensive details on the distribution and size of prostate cancer cells.

Axumin can be utilized in males with PSA levels as low as ten for early testing and find than ever before, unlike CT (computed tomography) or bone scans that need accelerations of PSA levels to ten to 50 to reveal cancer. Because it is a nuclear scan, Axumin can also pinpoint the precise location of prostate cancer when it is still very small and distinguish between a more aggressive, systemic recurrence that has metastasized to other areas and a contained, local recurrence, aiding in the selection of the most appropriate treatment.

How Does an Axumin PET Scan Work for Prostate Cancer?

Since prostate cancer cells can absorb the synthetic amino acid Fluciclovine, it can be used to identify prostate cancer that has returned after initial therapy or migrated to other body regions.

1. The radiotracer is injected into the patient during the operation, and the radioactive emissions from the tracer are subsequently detected using a PET scanner. The generated pictures offer comprehensive details on the distribution and size of prostate cancer cells.

2. Understanding the underlying concepts of PET imaging is crucial to comprehend how the Axumin PET scan for prostate cancer functions. PET is a nuclear medicine imaging that creates 3D pictures of the body's organs and tissues using tiny quantities of radioactive chemicals. A radiotracer is injected into the patient's bloodstream for PET imaging, where it travels to the target location. The radiotracer releases positrons into the body's tissues, which strike off electrons to create gamma rays that the PET scanner can pick up. The generated pictures display the location of the radiotracer throughout the body and reveal details on the metabolism and operation of the organs and tissues.

3. Prostate cancer cells absorb the radiotracer Fluciclovine because they require many amino acids to promote their development and proliferation. The PET scanner detects radioactive emissions from the tracer inside these cancer cells, which produces pictures that can aid medical professionals in identifying and pinpointing the cancer cells.

4. As it can be challenging to discriminate between recurring cancer and scar tissue or other benign illnesses with conventional imaging tests, an Axumin PET scan is particularly helpful for detecting recurrent prostate cancer, which has returned after initial therapy. Moreover, it can be utilized to find cancer that has migrated to other bodily regions. Overall, the Axumin PET scan is a major improvement in the treatment of prostate cancer and can enhance patient outcomes.

What Is the Difference Between Axumin PET Scan v/s Other Imaging Examinations for Prostate Cancer?

When identifying recurring prostate cancer, an Axumin PET scan has proven more reliable than other imaging procedures, including bone or computed tomography (CT) scans.

1. Bone Scans: Metastatic prostate cancer, which has migrated to the bones, is frequently found using bone scans. Nevertheless, the capacity of bone scans to identify tiny or early metastatic tumors might be restricted. It has been demonstrated that Axumin PET scans are more accurate than bone scans at identifying bone metastases in men with prostate cancer.

2. CT Scans: A CT scan can detect cancer that has spread to other organs or tissues. However, scar tissue or other benign disorders can occasionally be misinterpreted for malignancy, making CT scans inconclusive. In individuals who have already had initial therapy, it has been demonstrated that Axumin PET scans are more reliable than CT scans at identifying recurring prostate cancer.

3. Axumin Scans: Overall, compared to other imaging tests, the Axumin PET scan is a more sensitive and specific imaging test for detecting recurrent prostate cancer, making it an important tool in the diagnosis and treatment of prostate cancer. It can assist in directing treatment choices and enhancing patient outcomes. It is crucial to remember that the Axumin PET scan is a complementary tool that can offer more information rather than a substitute for other imaging examinations.

What Are the Side Effects of an Axumin PET Scan for Prostate Cancer?

The Axumin PET scan is often considered safe and well-tolerated, with few adverse effects. The radiotracer utilized in the scan, Fluciclovine (18F), has a relatively short half-life and is quickly excreted from the body, lowering the danger of radiation exposure. Axumin PET scan does, however, include a small risk of adverse consequences, just like any medical procedure. The following are some of the most frequent adverse reactions to the radiotracer injection:

1. There is little discomfort or soreness at the injection site.

2. Headache.

3. Nausea.

4. Dizziness.

5. Usually minor and transient, these side effects go away without medical intervention.

Rarely, a patient may get a radiotracer allergy response. An allergic response may cause the following symptoms:

1. Irritation or hives.

2. Face, lips, or tongue swelling.

3. Having trouble breathing.

The patient should report these symptoms to the doctor as soon as possible. If a patient has any allergies or illnesses that might compromise the safety of the treatment, they should also disclose this to their healthcare professional.

What Are the Recent Advancements in Imaging Techniques for Prostate Cancer?

Apart from the Axumin PET scan, another scan used is PSMA PET. In this type of imaging, the physiologic tracer uptake can be observed in lacrimal glands, salivary glands, liver, spleen, small intestine, colon, rectum, and kidneys. The normal excretion of radiotracer is through the urinary system, and a small part is excreted through the hepatobiliary system. The overexpression of PSMA has been observed in prostate cancer in past decades, and the recent FDA approval of PSMA-ligand PET agents has become a recent update. The advantage of PSMA-ligand PET agents is that there is no upregulation or raised radiotracer activity in benign prostatic hyperplasia (BPH). It was found that PSMA can have a superior degree of sensitivity and specificity for osseous metastasis. It can be used along with MRI (magnetic resonance imaging) to have improved sensitivity and specificity.

Future radiotracers include 16ꞵ-18F–5a-dihydrotestosterone (18-F-FDHT). It is a structural analog of a 5a-dihydrotestosterone (DHT) that helps bind the androgen receptor (AR). 18F-FDHT can help determine the prognosis and survival among those with metastatic castrate-resistant prostate cancer.

Miscellaneous radiotracers include gastrin-releasing peptide receptors (GRPR) and G-protein coupled receptors, useful for prostate cancer imaging. Bombesin, a 14-amino acid peptide, once labeled to Gallium-68, targets the GRPR in prostate cancer as an agonist. Cell surface protein 6 transmembrane epithelial antigen of prostate 1 (STEAP 1) is an androgen-regulated gene that is targeted.

Conclusion

As a result, the Axumin PET scan is an important tool in detecting and treating prostate cancer. It is a sensitive and specific imaging test that may accurately identify metastases to other body areas and recurring prostate cancer. An important development in the treatment of prostate cancer is the Axumin PET scan, which can assist with treatment decisions, track patient response to treatment, and enhance patient outcomes. It is a crucial tool for doctors to diagnose and treat prostate cancer, and as more study is done to determine its efficacy, its use is likely to grow.