The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Hoffmann, Manuela Andrea; Buchholz, Hans‐Georg; Wieler, H.; Höfner, Thomas; Müller-Hübenthal, Jonas; Trampert, L.; Schreckenberger, Mathias

doi:10.18632/oncotarget.27239

Cited by 17 publications

(13 citation statements)

References 31 publications

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“…Hoffmann et al reported that patients with PSA relapse had an S shaped relation between the PSA levels before 68 Ga-PSMA PET/CT and the rate of positive findings on their 68 Ga-PSMA PET/CT scans [ 18 ]. Patients with positive sites in regional lymph nodes and bones had higher median PSA values before 68 Ga-PSMA PET/CT than those with positive sites in the prostate bed.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, many patients with PSA relapse who have a short PSADT <3 months and cancers that have a high ISUP grade 5 progress to metastatic cancer and cancer-specific death despite salvage treatment. Compared with conventional imaging modalities such as CT and bone scans, the 68 Ga-PSMA PET/CT scan has a relatively high sensitivity, especially for patients with PSA relapse and PSA levels <2 ng/mL [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Today, the Federal Drug Administration (FDA) in the USA and many guidelines recommend that urologists and oncologists examine patients with PSA relapse with 68 Ga-PSMA PET/CT [ 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

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68Ga-PSMA PET/CT for Patients with PSA Relapse after Radical Prostatectomy or External Beam Radiotherapy

2021

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The study aimed to summarize clinical characteristics associated with Gallium-68-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (68Ga-PSMA PET/CT) scans as patients were restaged for prostate-specific antigen (PSA) relapse after radical prostatectomy (RP) or external beam radiotherapy (EBRT). Our analyses included multiple cox regression analyses. The study evaluated 95 patients with rising values of PSAs after RP and after EBRT. Sixty 63% of patients had a positive 68Ga-PSMA PET/CT scan. Twelve patients (13%) had a positive site in the prostate bed, 29 patients (30%) had a positive site in the regional lymph nodes, and 19 (20%) had positive sites in distant organs. After four years follow-up, 21 patients (22%) died. Using multiple Cox regression analyses, the number of positive sites on the 68Ga-PSMA PET/CT scan significantly predicted overall survival (OS) (p = 0.0001), whereas risk score and regional locations of the positive sites were not significant in the multiple Cox regression analyses. Our study indicates that the specific findings of 68Ga-PSMA PET/CT scans are important because detailed findings of the scans predict the outcome after salvage treatment of patients with PSA relapse examined with 68Ga-PSMA PET/CT scans.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

68Ga-PSMA PET/CT for Patients with PSA Relapse after Radical Prostatectomy or External Beam Radiotherapy

2021

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“…Multiple studies have con rmed a high detection rate of recurrent PCa with various PSMA-targeting radiotracers even in biochemical recurrence patients with low PSA levels, and usually exceeds mpMRI (27)(28)(29). Some studies suggest a strong correlation between PSA levels and diagnostic performance of PSMA-targeting PET tracers (27)(28)(29)(30)(31). Our small sample size cohort did not allow for such a correlation, however in a future study with a larger cohort, imaging results should be correlated with PSA levels to test whether this holds true in patients who have undergone brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI and 18F-DCFPyL PET/CT for Detection of Locally Recurrent Prostate Cancer After Low dose Rate Brachytherapy

Walker¹,

Fernandez²,

Roy³

et al. 2020

Preprint

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Background and purpose: Both multiparametric magnetic resonance imaging (mpMRI) and prostate specific membrane antigen (PSMA)-targeting positron emission tomography (PET) imaging have shown promise in early localization of prostate cancer (PCa) recurrence after primary external beam radiotherapy. Detecting recurrence after brachytherapy for PCa using MRI is significantly hampered by susceptibility artifacts secondary to brachy seeds. Here, we compare the efficacy of 18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) PET/CT versus mpMRI for detecting sites of local recurrence after low dose rate (LDR) brachytherapy for prostate cancer. Materials and methods: A total of 155 patients with a history of recurrent PCa who underwent mpMRI at 3 Tesla and 18F-DCFPyL PET/CT were retrospectively reviewed. Patients who underwent LDR brachytherapy for PCa and had subsequent biochemical recurrence (BCR) followed by mpMRI and 18F-DCFPyL PET/CT were included in this study. mpMRI was performed on a 3T scanner with endorectal and surface coils and images were prospectively read by a single expert radiologist. The 18F-DCFPyL PET/CT scan was prospectively interpreted by one of two nuclear medicine physicians. Patients underwent targeted biopsy when deemed clinically necessary and specimens were interpreted by an expert GU pathologist. Positivity rates (PR) from mpMRI and 18F-DCFPyL PET/CT were compared, and pathology results were used to calculate the positive predictive value (PPV) of each imaging modality for detecting PCa recurrence.Results: 14 patients who underwent LDR brachytherapy and had subsequent biochemical failure were imaged with mpMRI and 18F-DCFPyL PET/CT. 17 lesions were identified on at least one imaging modality. The PR for detection of intraprostatic lesions was 71% (10/14) for PET/CT and 64.3% (9/14) for mpMRI. 18F-DCFPyL PET/CT identified pelvic and extra-pelvic lymph nodes in 8 (57%) patients, while mpMRI noted positive lymph node findings in only 2 (14%) patients. A total of 14 lesions corresponding to 8 patients were targeted for biopsy and in these, 18F-DCFPyL PET/CT performed better than mpMRI for the detection of local recurrence with a PPV of 81.8% vs. 66.7%. For the detection of intraprostatic lesions, 18F-DCFPyL PET/CT and mpMRI had a PPV of 87.5% and 71.4%, respectively. Conclusion: Our findings suggest that 18F-DCFPyL PET/CT detects local and regional recurrent PCa after LDR brachytherapy at a higher rate than mpMRI and has a much higher detection rate of suspicious pelvic lymph nodes. Further studies are needed to validate these findings in larger cohorts.

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“…Multiple studies have con rmed a high detection rate of recurrent PCa with various PSMA-targeting radiotracers even in biochemical recurrence patients with low PSA levels, and usually exceeds mpMRI (28)(29)(30). Some studies suggest a strong correlation between PSA levels and diagnostic performance of PSMA-targeting PET tracers (28)(29)(30)(31)(32). Our small sample size cohort did not allow for such a correlation, however in a future study with a larger cohort, imaging results should be correlated with PSA levels to test whether this holds true in patients who have undergone brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI and 18F-DCFPyL PET/CT for detection of locally recurrent prostate cancer after low dose rate brachytherapy

Walker¹,

Fernández²,

Roy³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background and purpose: Both multiparametric magnetic resonance imaging (mpMRI) and prostate specific membrane antigen (PSMA)-targeting positron emission tomography (PET) imaging have shown promise in early localization of prostate cancer (PCa) recurrence after primary external beam radiotherapy. Detecting recurrence after brachytherapy for PCa using MRI is significantly hampered by susceptibility artifacts secondary to brachy seeds. Here, we compare the efficacy of 18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) PET/CT versus mpMRI for detecting sites of local recurrence after low dose rate (LDR) brachytherapy for prostate cancer.Materials and methods: A total of 155 patients with a history of recurrent PCa who underwent mpMRI at 3 Tesla and 18F-DCFPyL PET/CT were retrospectively reviewed. Patients who underwent LDR brachytherapy for PCa and had subsequent biochemical recurrence (BCR) followed by mpMRI and 18F-DCFPyL PET/CT were included in this study. mpMRI was performed on a 3T scanner with endorectal and surface coils and images were prospectively read by a single expert radiologist. The 18F-DCFPyL PET/CT scan was prospectively interpreted by one of two nuclear medicine physicians. Patients underwent targeted biopsy when deemed clinically necessary and specimens were interpreted by an expert GU pathologist. Positivity rates (PR) from mpMRI and 18F-DCFPyL PET/CT were compared, and pathology results were used to calculate the positive predictive value (PPV) of each imaging modality for detecting PCa recurrence.Results: 15 patients who underwent LDR brachytherapy and had subsequent biochemical failure were imaged with mpMRI and 18F-DCFPyL PET/CT. 18 non-lymph node lesions were identified on at least one imaging modality. The PR for detection of intraprostatic lesions was 60% (9/15) for both PET/CT and mpMRI, with 3 prostate lesions detected by only one modality. 18F-DCFPyL PET/CT identified pelvic and extra-pelvic lymph nodes in 8 (53%) patients, while mpMRI noted positive lymph node findings in only 2 (13%) patients. A total of 15 lesions corresponding to 9 patients were targeted for biopsy. The PPV of 18F-DCFPyL PET/CT and mpMRI for the detection of local recurrence were 84.6% and 71.4%, respectively. For the detection of intraprostatic lesions, 18F-DCFPyL PET/CT and mpMRI had a PPV of 87.5% and 71.4%, respectively. Conclusion: This case series analysis suggests that 18F-DCFPyL PET/CT may detect local and regional recurrent PCa after LDR brachytherapy at a higher rate than mpMRI and that it has the potential to detect suspicious pelvic lymph nodes at a much higher rate. Further studies are needed to validate these findings in larger cohorts.

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The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Cited by 17 publications

References 31 publications

68Ga-PSMA PET/CT for Patients with PSA Relapse after Radical Prostatectomy or External Beam Radiotherapy

68Ga-PSMA PET/CT for Patients with PSA Relapse after Radical Prostatectomy or External Beam Radiotherapy

Multiparametric MRI and 18F-DCFPyL PET/CT for Detection of Locally Recurrent Prostate Cancer After Low dose Rate Brachytherapy

Multiparametric MRI and 18F-DCFPyL PET/CT for detection of locally recurrent prostate cancer after low dose rate brachytherapy

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