Detection of Local, Regional, and Distant Recurrence in Patients With PSA Relapse After External-Beam Radiotherapy Using 11C-Choline Positron Emission Tomography

Breeuwsma, A.J.; Pruim, Jan; Bergh, Alphons C.M. van den; Leliveld, Anna M.; Nijman, Rien J.M.; Dierckx, Rudi; Jong, Igle J. de

doi:10.1016/j.ijrobp.2009.04.090

Cited by 83 publications

(39 citation statements)

References 21 publications

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“…The detection efficacy of 90.7% for 68 Ga-PSMA ligand PET/CT in our patient cohort is slightly higher than those in the before-mentioned studies, ranging between 80.4% and 87.8%. However, with respect to the results of Breeuwsma et al (19), the median PSA in our patient population was lower (median PSA . Nevertheless, our study demonstrates substantial detection efficacies for 68 Ga-PSMA ligand PET/CT after primary RT, which is in the range of previous studies (68%-89%) reported for patients with BCR who had been predominantly treated with radical prostatectomy (10,13,22).…”

Section: Discussioncontrasting

confidence: 78%

“…As an important finding, 68 Ga-PSMA ligand PET/CT showed positive findings outside the prostate in 59.8% of patients. Comparable results (i.e., 62.6%) are reported by Ceci et al for 11 C-choline PET/CT (8 (8,19). Notably, the detection or exclusion of local recurrence after primary RT and the finding of metastatic disease not amenable for surgical resection are crucial in view of a potential radical salvage prostatectomy in carefully selected patients (PSA , 10 ng/mL, PSA doubling time .…”

Section: Discussionmentioning

confidence: 69%

“…To our knowledge, only 3 prior reports, involving 46, 70, and 140 patients, respectively, have investigated the value of 11 C-or 18 F-labeled choline PET/CT imaging in detecting recurrent PC after EBRT or brachytherapy (8,19,21). The detection efficacy of 90.7% for 68 Ga-PSMA ligand PET/CT in our patient cohort is slightly higher than those in the before-mentioned studies, ranging between 80.4% and 87.8%.…”

Section: Discussionmentioning

confidence: 99%

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Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

et al. 2017

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The aim of this retrospective study was to evaluate the detection rate of Glu-NH-CO-NH-Lys-(Ahx)-[ 68 Ga(HBED-CC)] ( 68 Ga-PSMA ligand; PSMA is prostate-specific membrane antigen) PET/CT in patients with biochemical recurrent prostate cancer defined by Phoenix criteria after external-beam radiotherapy or brachytherapy as primary treatment. Methods: One hundred eighteen patients with a median prostate-specific antigen (PSA) of 6.4 ng/mL (range, 2.2-158.4 ng/mL; interquartile range, 4.2-10.2 ng/mL) were finally eligible for this retrospective analysis. Seventy-seven and 41 patients had been treated by external-beam radiotherapy or brachytherapy, respectively. Of the 118 patients, 45 were receiving androgen-deprivation therapy (ADT) within at least 6 mo before the PET/CT. The detection rates were stratified by PSA. The influence of primary Gleason score and ADT was assessed. Relationships between SUV and clinical as well as pathologic features in patients with positive findings were analyzed using univariate and multivariable linear regression models. Results: One hundred seven of 118 patients (90.7%) showed pathologic findings indicative for tumor recurrence in 68 Ga-PSMA ligand PET/CT. The detection rates were 81.8% (36/44), 95.3% (41/43), and 96.8% (30/31) for PSA of 2 to ,5, 5 to ,10, and $10 ng/mL, respectively (P 5 0.0377). 68 Ga-PSMA ligand PET/CT indicated local recurrence in 68 of 107 patients (63.5%), distant lesions in 64 of 107 patients (59.8%), and local recurrence as well as distant lesions in 25 of 107 patients (23.4%). The detection rate was significantly higher in patients with ADT (97.7%) versus without ADT (86.3%, P 5 0.0381), but independent from primary Gleason score $ 8 (92.0%) versus # 7 (90.2%, P 5 0.6346). SUV max and SUV mean were significantly associated with PSA and ADT (P 5 0.018 and 0.004 for SUV max , respectively; P 5 0.025 and 0.007 for SUV mean , respectively). Conclusion: 68 Ga-PSMA ligand PET/CT demonstrates high detection rates in patients with biochemical recurrence of prostate cancer after primary radiation therapy. The detection rate was positively associated to increasing PSA as well as concomitant ADT. 68 Ga-PSMA ligand PET/CT enables discrimination of local versus metastatic disease and thus might have a crucial impact on further clinical management. A major limitation of this study is the lack of histopathologic proof in most patients.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

et al. 2017

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“…These variations could be attributed to the heterogeneity of patient populations in terms of inclusion criteria (i.e., PSA level, staging, and presence or absence of androgen deprivation therapy [ADT]). In addition to the largely documented influence of serum PSA measurement on the rate of detection of PCa recurrence by 11 C-choline PET/CT (10,14,15), several studies have reported that PSA kinetics, including PSA doubling time (PSAdt) and PSA velocity (PSAvel), are strong predictors for positive PET scan results.…”

Section: Influence Of Psa On Rate Of Detection By 11 C-choline Pet/ctmentioning

confidence: 99%

¹¹C- or ¹⁸F-Choline PET/CT for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer

et al. 2016

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Recurrence of prostate cancer is suspected when an increase in the prostate-specific antigen level is detected after radical treatment; the recurrence could be local relapse, distant relapse, or both. Differentiation between the two patterns of relapse is critical for choosing the proper treatment strategy. Choline PET/CT could be of help in discriminating patients with local, lymph node, and bone recurrences, thus having an impact on patient management.

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“…Ein NPW von nur 44%, eine Vielzahl verschiedener Validierungsmethoden und die Verwendung eines nicht integrierten PET/CT-Systems mit nachträglicher Fusionierung der Bilddatensätze erlauben noch keine suffiziente Aussage über den Stellenwert der Cholin-PET/CT in diesem Szenario, insbesondere nicht für die sichere Diagnostik des rein intraprostatischen Rezidivs [27]. Die Differenzierung der Tracerakkretion in Tumorrezidiv und bestrahltem rezidivfreiem Gewebe mit oder ohne inflammatorische Komponente ist außerdem bislang schlecht definiert [28,29].…”

Section: Das Cholin-pet/ct In Der Rezidivdiagnostikunclassified

Das Cholin-PET/CT in der Primär- und Rezidivdiagnostik des Prostatakarzinoms

Olbert

Heinis

Hofmann

et al. 2012

Urologe

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Overdiagnosis and resulting overtreatment in prostate cancer are under intensive discussion both in the urologic communities and in the public media. Sensitive and specific diagnostic modalities could be one step forward to overcome this problem. Choline PET/CT provides fusion imaging that combines anatomical/morphological information with metabolic/functional data. Despite promising preclinical data and interesting initial clinical results, this cost-intensive and logistically demanding technology has not yet found its way into routine clinical practice; the German and European guideline recommendations are careful and reluctant. This review has the goal to give an overview of the recent data both on initial diagnosis and on staging/diagnosis for biochemical recurrence by choline PET/CT and to summarize the possible role of this innovative technology in the future, if adequate research projects can be realized.

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Detection of Local, Regional, and Distant Recurrence in Patients With PSA Relapse After External-Beam Radiotherapy Using 11C-Choline Positron Emission Tomography

Cited by 83 publications

References 21 publications

Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

¹¹C- or ¹⁸F-Choline PET/CT for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer

Das Cholin-PET/CT in der Primär- und Rezidivdiagnostik des Prostatakarzinoms

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Detection of Local, Regional, and Distant Recurrence in Patients With PSA Relapse After External-Beam Radiotherapy Using 11C-Choline Positron Emission Tomography

Cited by 83 publications

References 21 publications

Detection Efficacy of Hybrid 68Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

Detection Efficacy of Hybrid 68Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

11C- or 18F-Choline PET/CT for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer

Das Cholin-PET/CT in der Primär- und Rezidivdiagnostik des Prostatakarzinoms

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Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

Detection Efficacy of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in Prostate Cancer Patients with Biochemical Recurrence After Primary Radiation Therapy Defined by Phoenix Criteria

¹¹C- or ¹⁸F-Choline PET/CT for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer