Impact of Ga-68-PSMA PET/CT on management in prostate cancer patients with very early biochemical recurrence after radical prostatectomy

File Description SizeFormat 
Bashir2019_Article_ImpactOfGa-68-PSMAPETCTOnManag.pdfPublished version3.58 MBAdobe PDFView/Open
Title: Impact of Ga-68-PSMA PET/CT on management in prostate cancer patients with very early biochemical recurrence after radical prostatectomy
Authors: Bashir, U
Tree, A
Mayer, E
Levine, D
Parker, C
Dearnaley, D
Oyen, WJG
Item Type: Journal Article
Abstract: Purpose: With the availability of ultra-sensitive PSA assays, early biochemical relapse (eBCR) of prostate cancer is increasingly being detected at values much lower than the conventional threshold of 0.2 ng/ml. Accurate localisation of disease in this setting may allow treatment modification and improved outcomes, especially in patients with pelvis-confined or extra-pelvic oligometastasis (defined as up to three pelvic nodal or distant sites). We aimed to measure the detection rate of [68]Ga-PSMA-HBNED-CC (PSMA)-PET/CT and its influence on patient management in eBCR of prostate cancer following radical prostatectomy (RP). Methods: We retrospectively identified 28 patients who underwent PSMA-PET/CT for post-RP eBCR (PSA < 0.5 ng/ml) at our tertiary care cancer centre. Two nuclear medicine physicians independently recorded the sites of PSMA-PET/CT positivity. Multidisciplinary meeting records were accessed to determine changes in management decisions following PSMA-PET/CT scans. Results: The mean age of patients was 65.6 years (range: 50–76.2 years); median PSA was 0.22 ng/ml (interquartile range: 0.15 ng/ml to 0.34 ng/ml). Thirteen patients (46.4%) had received radiotherapy in the past. PSMA-PET/CT was positive in 17 patients (60.7%). Only one patient had polymetastasis (> 3 sites); the remainder either had prostatectomy bed recurrence (n = 2), pelvic oligometastasis (n = 10), or extra-pelvic oligometastasis (n = 4). PSMA-PET/CT resulted in management change in 12 patients (42.8%), involving stereotactic body radiotherapy (n = 6), salvage radiotherapy (n = 4), and systemic treatment (n = 2). Conclusions: Our findings show that PSMA-PET/CT has a high detection rate in the eBCR setting following RP, with a large proportion of patients found to have fewer than three lesions. PSMA-PET/CT may be of value in patients with early PSA failure, and impact on the choice of potentially curative salvage treatments.
Issue Date: 1-Apr-2019
Date of Acceptance: 26-Dec-2018
URI: http://hdl.handle.net/10044/1/69367
DOI: https://doi.org/10.1007/s00259-018-4249-z
ISSN: 1619-7070
Publisher: Springer
Start Page: 901
End Page: 907
Journal / Book Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 46
Issue: 4
Copyright Statement: © 2019 The Authors. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor/Funder: Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: UR150
RDB04
Keywords: PSMA-PET/CT
Prostate cancer
Recurrence
1103 Clinical Sciences
0299 Other Physical Sciences
Nuclear Medicine & Medical Imaging
Publication Status: Published
Online Publication Date: 2019-01-08
Appears in Collections:Division of Surgery



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commonsx