Initial Experience of 68Ga-PSMA PET/CT Imaging in High-risk Prostate Cancer Patients Prior to Radical Prostatectomy

Budäus, Lars; Leyh-Bannurah, Sami-Ramzi; Salomon, Georg; Michl, Uwe; Heinzer, Hans; Huland, Hartwig; Graefen, Markus; Steuber, Thomas; Rosenbaum, Clemens M.

doi:10.1016/j.eururo.2015.06.010

Cited by 399 publications

(305 citation statements)

References 13 publications

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“…In a large series of patients (n 5 248) with biochemical recurrence after radical prostatectomy, although close to 90% had a positive PSMA scan, when the PSA was 0.2-, 0.5 ng/mL, this rate fell to 58% (17). Similarly, in a Turkish multicenter study involving 31 patients, the mean diameter of nodes that were false-negative on PSMA PET/CT was only 3.9 mm (18), which confirmed earlier results indicating that those pathologically involved nodes that were not detected were significantly smaller than nodes that were (19). Thus, it is likely that those patients with a negative scan have a smaller volume of disease than those with a positive scan.…”

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confidence: 75%

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

2017

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supporting

confidence: 75%

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

2017

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“…To our knowledge, there have been only 2 publications reporting PSMA uptake in the prostate before RPE (20,21). Budäus et al reported only about the use of 68 Ga-PSMA to visualize cancer in the prostate gland (20).…”

Section: Discussionmentioning

confidence: 99%

“…Budäus et al reported only about the use of 68 Ga-PSMA to visualize cancer in the prostate gland (20). Using a 12-segment model, Rowe et al showed a poor sensitivity of 10% and accuracy of 56% for detection of malignant prostate lesions in a stringent analysis of an 18 …”

Section: Discussionmentioning

confidence: 99%

Correlation of Intraprostatic Tumor Extent with ⁶⁸Ga-PSMA Distribution in Patients with Prostate Cancer

et al. 2016

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We evaluated the diagnostic value and accuracy of prostatespecific membrane antigen (PSMA) PET for the intraprostatic delineation of prostate cancer before prostatectomy. Methods: We identified 6 patients with biopsy-proven high-risk prostate cancer who were referred for 68 Ga-PSMA PET/CT before radical prostatectomy to rule out metastasis. After prostatectomy, a histologic map of the prostate was reconstructed. The histologic extent and Gleason score of each segment of the prostate were compared with 68 Ga-PSMA PET images resliced to the histologic axis. Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios were calculated. The SUV of each segment was measured, and median values were compared. Results: Of the 132 segments, 112 were eligible for analysis. The correlation of histologic results with 68 Ga-PSMA PET images showed a specificity and sensitivity of 92%. The positive and negative likelihood ratio and the positive and negative predictive value for detection of prostate cancer on 68 Ga-PSMA PET were 11.5, 0.09, 96%, and 85%, respectively. The median SUV max of true-positive prostate segments was significantly higher than that of true-negative segments (11.0 ± 7.8 vs. 2.7 ± 0.9, P , 0.001), and a cutoff of 4 revealed a sensitivity and specificity of 86.5% and an accuracy of 87.5%. Conclusion: These preliminary results show that the intraprostatic localization and extent of prostate cancer may be estimated by 68 Ga-PSMA PET. This imaging method may be helpful for identifying target lesions before prostate biopsy and may support decision making before focal or radical therapy.

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“…PSMA is a transmembrane protein that is highly overexpressed (100-to 1,000-fold) on almost all PC tumors (16)(17)(18)(19). Only 5%-10% of primary PC lesions have been shown to be PSMA-negative (20,21). PSMA expression levels increase with higher tumor stage and grade (16,18,22).…”

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confidence: 99%

PSMA Ligands for PET Imaging of Prostate Cancer

et al. 2017

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Initial Experience of 68Ga-PSMA PET/CT Imaging in High-risk Prostate Cancer Patients Prior to Radical Prostatectomy

Cited by 399 publications

References 13 publications

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

Correlation of Intraprostatic Tumor Extent with ⁶⁸Ga-PSMA Distribution in Patients with Prostate Cancer

PSMA Ligands for PET Imaging of Prostate Cancer

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Initial Experience of 68Ga-PSMA PET/CT Imaging in High-risk Prostate Cancer Patients Prior to Radical Prostatectomy

Cited by 399 publications

References 13 publications

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

Correlation of Intraprostatic Tumor Extent with 68Ga-PSMA Distribution in Patients with Prostate Cancer

PSMA Ligands for PET Imaging of Prostate Cancer

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Product

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Correlation of Intraprostatic Tumor Extent with ⁶⁸Ga-PSMA Distribution in Patients with Prostate Cancer