Efficacy, Predictive Factors, and Prediction Nomograms for  68 Ga-labeled Prostate-specific Membrane Antigen–ligand Positron-emission Tomography/Computed Tomography in Early Biochemical Recurrent Prostate Cancer After Radical Prostatectomy

Rauscher, Isabel; Düwel, Charlotte; Haller, Bernhard; Rischpler, Christoph; Heck, Matthias; Gschwend, Jürgen E.; Schwaiger, Markus; Maurer, Tobias; Eiber, Matthias

doi:10.1016/j.eururo.2018.01.006

Cited by 141 publications

(129 citation statements)

References 14 publications

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“…63 A recently published study by the present authors of 272 patients with early biochemical recurrence after radical prostatectomy showed similar results, with PSMA-positive lesions detected in 74 out of 134 patients (55%, 95% CI 46-64) with a PSA value of 0.2-0.5 ng/mL, and in 102 out of 138 patients (74%, 95% CI 66-81) with a PSA value >0.5-1.0 ng/mL. 64 The main sites of recurrence were pelvic or retroperitoneal lymph nodes metastases, followed by local recurrence. In a multivariable logistic regression model, concurrent androgen deprivation therapy and PSA values were identified as the most relevant predictors of positive 68 Ga-PSMA-11 PET.…”

Section: From 18 F-fdg To 11 C-cholinesupporting

confidence: 82%

“…pooling 10 different studies showed a predicted positive rate of PSMA ligand PET of 42%, 58%, 76% and 95% for PSA values of 0–0.2, 0.2–1, 1–2 and >2 ng/mL, respectively . A recently published study by the present authors of 272 patients with early biochemical recurrence after radical prostatectomy showed similar results, with PSMA‐positive lesions detected in 74 out of 134 patients (55%, 95% CI 46–64) with a PSA value of 0.2–0.5 ng/mL, and in 102 out of 138 patients (74%, 95% CI 66–81) with a PSA value >0.5–1.0 ng/mL . The main sites of recurrence were pelvic or retroperitoneal lymph nodes metastases, followed by local recurrence.…”

Section: Prostate Cancersupporting

confidence: 76%

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Positron‐emission tomography imaging in urological oncology: Current aspects and developments

et al. 2018

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Positron-emission tomography/computed tomography combining both functional and morphological information has emerged as a powerful tool in oncological imaging within the past decades. The most commonly used radiotracer in oncology visualizing metabolic information is 2-[18F]fluoro-2-deoxy-d-glucose. However, the use of 2-[18F]fluoro-2-deoxy-d-glucose in urological oncology is challenging, as it is limited by physiological excretion through the urinary system. Therefore, it is only useful when applied to specific indications in selected patients with urological malignancy; for example, for detection of residual disease in the post-chemotherapy management of patients with seminoma. Despite initial promising results in bladder cancer, no relevant additional diagnostic value with positron-emission tomography using 2-[18F]fluoro-2-deoxy-d-glucose or choline-based tracers could be obtained, and should therefore be used with caution or only within clinical trials. In prostate cancer, however, a paradigm shift in imaging can be observed after development of new tracers that target the prostate-specific membrane antigen. Biochemical recurrent prostate cancer has become a clinically widely accepted indication for prostate-specific membrane antigen ligand positron-emission tomography/computed tomography, with several studies showing superior detection efficacy compared with conventional imaging. For primary high-risk prostate cancer, growing evidence suggests well-improved staging. The present review aimed to provide an overview of the current status of positron-emission tomography imaging in cancer of the urogenital system including the latest advances in Ga-labeled and F-labeled positron-emission tomography agents targeting the prostate-specific membrane antigen for positron-emission tomography imaging of prostate cancer.

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Section: From 18 F-fdg To 11 C-cholinesupporting

confidence: 82%

Section: Prostate Cancersupporting

confidence: 76%

Positron‐emission tomography imaging in urological oncology: Current aspects and developments

et al. 2018

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“…Eighteen studies reported the detection rate of 68 Ga‐PSMA PET in patients with a PSA 0.20–0.49 ng/mL . Combined, this involved 1078 patients.…”

Section: Resultsmentioning

confidence: 99%

Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Luiting¹,

Leeuwen

Busstra³

et al. 2019

BJU International

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ObjectivesTo review the literature to determine the sensitivity and specificity of gallium-68 prostate-specific membrane antigen ( 68 Ga-PSMA) positron-emission tomography (PET) for detecting pelvic lymph node metastases in patients with primary prostate cancer (PCa), and the positive predictive value in patients with biochemical recurrence (BCR) after initial curative treatment, and, in addition, to determine the detection rate and management impact of 68 Ga-PSMA PET in patients with BCR after radical prostatectomy (RP). Materials and MethodsWe performed a comprehensive literature search. Search terms used in MEDLINE, EMBASE and Science Direct were '(PSMA, 68 Ga-PSMA, 68 Gallium-PSMA, Ga-68-PSMA or prostate-specific membrane antigen)' and '(histology, lymph node, staging, sensitivity, specificity, positive predictive value, recurrence, recurrent or detection)'. Relevant abstracts were reviewed and full-text articles obtained where possible. References to and from obtained articles were searched to identify further relevant articles. ResultsNine retrospective and two prospective studies described the sensitivity and specificity of 68 Ga-PSMA PET for detecting pelvic lymph node metastases before initial treatment, which ranged from 33.3% to 100% and 80% to 100%, respectively. In eight retrospective studies, the positive predictive value of 68 Ga-PSMA PET in patients with BCR before salvage lymph node dissection ranged from 70% to 100%. The detection rate of 68 Ga-PSMA PET in patients with BCR after RP in the PSA subgroups <0.2 ng/mL, 0.2-0.49 ng/mL and 0.5 to <1.0 ng/ mL ranged from 11.3% to 50.0%, 20.0% to 72.7% and 25.0% to 87.5%, respectively. ConclusionThe review results showed that 68 Ga-PSMA PET had a high specificity for the detection of pelvic lymph node metastases in primary PCa. Furthermore, 68 Ga-PSMA PET had a very high positive predictive value in detecting lymph node metastases in patients with BCR. By contrast, sensitivity was only moderate; therefore, based on the currently available literature, 68 Ga-PSMA PET cannot yet replace pelvic lymph node dissection to exclude lymph node metastases. In the salvage phase, 68 Ga-PSMA PET had both a high detection rate and impact on radiotherapy planning in early BCR after RP. Keywords 68Ga-PSMA PET/CT, pelvic lymph node dissection, detection rate, pelvic lymph node metastases, #ProstateCancer, #PCSM Use of 68Ga-PSMA PET/CT after RP: review IQR, interquartile range; LNM, lymph node metastases. *Gallium-68 prostate-specific membrane antigen positron-emission tomography ( 68 Ga-PSMA PET)/MRI was used instead of 68 Ga-PSMA PET/CT. 208

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“…With PSA levels between 0.05 and 0.09 ng/ml 8% of patients had a positive PET/CT; 23% in the range 0.10–0.19 ng/ml and rising to 58% of patients with a PSA level of 0.20–0.29 ng/ml [11]. The 50% positive detection rate in patients with a PSA of 0.2–0.5 ng/ml is similar across differing studies [12, 13]. However, a systemic review of 37 published studies found a positive scan rate of 11–75% in patients with a PSA level of < 0.5 ng/ml [14].…”

Section: Introductionmentioning

confidence: 90%

Minimal residual disease in prostate cancer patients after primary treatment: theoretical considerations, evidence and possible use in clinical management

Murray

2018

Biol Res

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Minimal residual disease is that not detected by conventional imaging studies and clinically the patient remains disease free. However, with time these dormant cells will awaken and disease progression occurs, resulting in clinically and radiological detectable metastatic disease. This review addresses the concept of tumor cell dissemination from the primary tumor, the micrometastatic niche and tumor cell survival and finally the clinical utility of detecting and characterizing these tumor cells in order to guide management decisions in treating patients with prostate cancer.

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Efficacy, Predictive Factors, and Prediction Nomograms for 68 Ga-labeled Prostate-specific Membrane Antigen–ligand Positron-emission Tomography/Computed Tomography in Early Biochemical Recurrent Prostate Cancer After Radical Prostatectomy

Cited by 141 publications

References 14 publications

Positron‐emission tomography imaging in urological oncology: Current aspects and developments

Positron‐emission tomography imaging in urological oncology: Current aspects and developments

Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Minimal residual disease in prostate cancer patients after primary treatment: theoretical considerations, evidence and possible use in clinical management

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