The use of 68Ga-PET/CT PSMA in the staging of primary and suspected recurrent renal cell carcinoma

Raveenthiran, Sheliyan; Esler, Rachel; Yaxley, John; Kyle, Samuel

doi:10.1007/s00259-019-04432-2

Cited by 63 publications

(77 citation statements)

References 19 publications

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“…For instance, PSMA is expressed in the salivary glands, submandibular glands, kidneys, spleen, liver, and more. PSMA is also expressed in neovascularization of many solid tumors (11)(12)(13). Besides, many studied reported that peripheral nerve ganglia uptake PSMA (14).…”

Section: Introductionmentioning

confidence: 99%

Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

Shi

Zhu

et al. 2021

Front. Oncol.

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PurposeDifferentiating lymph node metastases (LNM) from peripheral ganglia by physiological prostate-specific membrane antigen (PSMA) uptake is challenging. Two tracers (68Ga-PSMA-11 and 18F-fluorodeoxyglucose [FDG]) metabolic uptake patterns were evaluated by positron emission tomography-computed tomography (PET-CT), searching for differences that could tell ganglia from LNM.MethodsDual 68Ga-PSMA-11 and 18F-FDG PET-CT data of 138 prostate cancer patients acquired from June 2018 to December 2019 were retrospectively evaluated. Ganglia and LNM with PSMA-11 uptake above local background were analyzed by the location and PSMA-11-PET and FDG-PET maximum standardized uptake value (SUVmax).ResultsPSMA-11-positive ganglia (n = 381) and LNM (n = 83) were identified in 138 and 58 patients, respectively. The LNM SUVmax of PSMA-11-PET (16.4 ± 14.8 vs 2.3 ± 0.7, P < 0.001) and FDG-PET (3.3 ± 3.2 vs 1.5 ± 0.5, P < 0.001) were higher than in ganglia. The probabilities of being an LNM in the low-potential (PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of <2.05), moderate-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of <2.05, or PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of >2.05), and high-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of >2.05) groups were 0.9% (3/334), 44.6% (37/83), and 91.5% (43/47), respectively (P < 0.001). The cervical and coeliac ganglia had higher PSMA-11 and FDG uptake than the sacral ganglia (P < 0.001 for all). LNM PSMA-11 and FDG uptake was similar in these three locations.ConclusionThe FDG-PET and PSMA-11-PET SUVmax, especially when combined, could well differentiate LNM from ganglia. The tracers uptake differed between cervical/coeliac and sacral ganglia, so the lesion location should be considered during image assessment.

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Section: Introductionmentioning

confidence: 99%

Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

Shi

Zhu

et al. 2021

Front. Oncol.

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“…A general clinical relevance of PSMA-PET/CT can be assumed, since a retrospective evaluation of Ga-68-PSMA-PET/CT examinations in RCC patients showed that PET/CT directly changed management in 42% of cases, 87.5% of PET-positive patients had ccRCC and one of eight ccRCC was PET-negative [ 18 ]. PET/CT with PSMA-targeting radiopharmaceuticals has the potential to assess the treatment response in ccRCC patients receiving tyrosine–kinase inhibitor or anti-angiogenic treatments [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

PSMA-PET/CT in Patients with Recurrent Clear Cell Renal Cell Carcinoma: Histopathological Correlations of Imaging Findings

et al. 2021

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PET/CT with prostate-specific membrane antigen (PSMA)-targeted tracers has been used in the diagnosis and staging of patients with clear cell renal cell carcinoma (ccRCC). For ccRCC primary tumors, PET parameters were shown to predict histologic grade and features. The aim of this study was to correlate PSMA PET/CT with histopathological findings in patients with metastatic recurrence of ccRCC. Patients with ccRCC who underwent PSMA-targeted PET/CT and subsequent histopathological evaluation of suspicious lesions were included. Specimens underwent immunohistochemical marking. Lesion diameter, volume and tracer uptake were correlated with the extent and intensity of molecular PSMA expression and with clinical findings. Twelve PET-positive lesions of nine patients were evaluated. Eleven ccRCC metastases and one prostate carcinoma were detected histopathologically. Molecular PSMA expression was detected in all lesions, which intensity and distribution did not correlate with PET parameters. PSMA-targeted PET/CT is a feasible tool for the evaluation of patients with ccRCC but cannot reliably predict histologic features of metastases. PSMA may also be expressed in malignant lesions other than ccRCC, leading to incidental detection of these tumors.

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“…68 Ga-PSMA-avid primary lesions were identified in 75% of cases, the majority of which were clear cell subtype. The 68 Ga-PSMA PET/CT findings altered the clinical management in 43.8% of the primary staging patients and in 40.9% of those undergoing restaging, and directly changed the management in 42.1% of patients following the identification of new sites of suspected metastases and the detection of synchronous primaries [27].…”

Section: Ga-psma Pet/ct Beyond Prostate Cancermentioning

confidence: 99%

Current status of radioligand therapy and positron-emission tomography with prostate-specific membrane antigen

et al. 2020

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Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed by prostate cancer cells. PSMA-based radioligand therapy (RLT) emerged as a promising therapeutic option for prostate cancer in the early 2000s, and has been clinically validated with great enthusiasm during these past two decades. Last year, the European Association of Nuclear Medicine (EANM) published the procedure guidelines for the safe clinical practice of Lutetium-177 (177Lu)-labelled PSMA RLT. In addition, PSMA RLT with alpha-ray-emitting radioisotopes has been also developed recently. Following the clinical use of 177Lu-PSMA RLT, PSMA-targeted positron-emission tomography (PET) with Gallium-68 (68Ga) has been performed inevitably for “theranostics” for the last decade; prostate cancer is going to be treated with PSMA-RLT based on the diagnosis by PSMA-PET. Furthermore, the diagnostic usefulness of 68Ga-PSMA PET has been documented in various diseases beyond prostate cancer more recently. Regrettably, Japan is behind European countries and the United States in this field, and has just made a belated start of their clinical trials. In this review article, we briefly overviewed the current status of PSMA RLT and PSMA PET. We hope that this topic will be a particular focus of attention for most ANM readers in Japan, and that our efforts will help to facilitate the early approval of PSMA RLT and PSMA PET by the Japanese government even if only slightly.

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The use of 68Ga-PET/CT PSMA in the staging of primary and suspected recurrent renal cell carcinoma

Cited by 63 publications

References 19 publications

Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

PSMA-PET/CT in Patients with Recurrent Clear Cell Renal Cell Carcinoma: Histopathological Correlations of Imaging Findings

Current status of radioligand therapy and positron-emission tomography with prostate-specific membrane antigen

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