Translational Molecular Imaging of Prostate Cancer

Prostate cancer is a heterogeneous disease, and its management is now evolving to become more personalized and to incorporate new targeted therapy. With these new changes comes a demand for molecular imaging techniques that not only detect disease but also assess biology and treatment response. This review article summarizes the current status of molecular imaging in prostate cancer (e.g. ^99m Tc bone scintigraphy and ¹⁸ F-fluorodeoxyglucose positron-emission tomography), with emphasis on emerging clinical and preclinical imaging agents, and their mechanism and clinical application. Emerging agents at different stages of clinical use include radiolabeled analogs of lipid, amino acid, and nucleoside metabolites, and agents more specifically targeting prostate cancer biomarkers, including androgen receptor, prostate-specific membrane antigen, and others. We also emphasize new techniques and targeted contrast agents for magnetic resonance imaging and spectroscopy. For all of these imaging techniques, a growing and important unfulfilled need is for well-designed prospective clinical trials which establish clear indications with clinical benefit in prostate cancer.