68 Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC): a prospective single-centre study in patient
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ORIGINAL ARTICLE
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Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC): a prospective single-centre study in patients eligible for salvage therapy Désirée Deandreis 1 & Alessia Guarneri 2 & Francesco Ceci 1 & Beatrice Lillaz 3 & Sara Bartoncini 2 & Marco Oderda 3 & Daniele Giovanni Nicolotti 1 & Emanuela Pilati 1 & Roberto Passera 1 & Andrea Zitella 3 & Marilena Bellò 1 & Ramona Parise 2 & Roberta Carlevato 2 & Umberto Ricardi 2,4 & Paolo Gontero 3 Received: 17 November 2019 / Accepted: 2 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives The primary objective is to assess the efficacy of 68Ga-PSMA-11-PET/CT to detect recurrent location(s) in hormonesensitive prostate cancer (PCa). Secondary objectives are (1) to evaluate changes in clinical management; (2) to determine which covariates independently predict positive scan; (3) to assess 68Ga-PSMA-11-PET/CT performance in different settings of PSA relapse. Materials and methods Inclusion criteria include (1) histologically diagnosed PCa; (2) previous radical therapy; (3) proven biochemical recurrence (BCR) or biochemical persistence (BCP); (4) hormone-sensitive PCa (HSPC); (5) androgen deprivation therapy (ADT)–free for at least 6 months; (6) PSA < 1.5 ng/mL or any PSA in case of negative choline-PET/CT (n = 38). Changes in clinical management were defined by multidisciplinary tumour-board. Clinical settings were BCP (group-1, n = 25); first-time BCR (group-2, n = 121); BCR after salvage therapy (group-3, n = 77). Results Two hundred twenty-three (223) consecutive patients were enrolled: median PSA = 0.65 ng/mL (0.2–8.9) and median PSAdt = 9.3 months (0.4–144.6). 96.9% received RP as primary therapy. 68Ga-PSMA-11-PET/CT positivity rate was 39.9% (CI95% 33.5–46.7%). Disease confined to pelvis was detected in 23.3% of cases. At least one distant lesion was observed in 16.6% of cases. Secondary objectives are as follows: (1) changes in clinical management were observed in 34.5% of patients; (2) PSA, PSAdt and T stage > 3a were independent predictors (all p < 0.03); (3) 68Ga-PSMA-11-PET/CT positivity rate was 56% (in group 1, 36.3% in group 2, 40.3% in group 3. Conclusion This study attested the overall good performance of 68Ga-PSMA-11-PET/CT to detect PCa locations in HSPC patients eligible for salvage therapy, influencing the therapy management in 35.4% of cases. Furthermore, patient characteristics are influencing factors of 68Ga-PSMA-11-PET/CT positivity rate and should be considered to reduce false negative scan. Keywords PSMA PET . Biochemical recurrence . Biochemical persistence . Salvage radiotherapy . PSMA . Prostate cancer . Prostate cancer change of management
This article is part of the Topical Collection on Oncology - Genitourinary. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00259-020-04809-8) contains supplementary material, which is available to authorized users. * Francesco Ceci [email protected] 1
Nuclear Medicine, Department of M
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