Clinicopathological predictors of positive 68 Ga-PSMA-11 PET/CT in PSA-only recurrence of localized prostate cancer foll
- PDF / 900,534 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 17 Downloads / 127 Views
ORIGINAL ARTICLE
Clinicopathological predictors of positive 68Ga-PSMA-11 PET/CT in PSA-only recurrence of localized prostate cancer following definitive therapy Ahmet Murat Aydin1 · Bahadir Haberal1 · Meylis Artykov1 · Cenk Yucel Bilen1 · Sertac Yazici1 Received: 10 December 2018 / Accepted: 21 January 2019 © The Japanese Society of Nuclear Medicine 2019
Abstract Objective To demonstrate the effect of clinicopathological factors on 68Ga-PSMA-11 PET/CT positivity at the time of biochemical recurrence (BCR) of localized prostate cancer (PCa) following definitive therapy. Methods We retrospectively reviewed our institutional database for PCa patients who had BCR and subsequently underwent 68 Ga-PSMA-11 PET/CT between April 2014 and February 2018. A total of 51 patients who were metastasis-free before PSMA imaging and previously treated with definitive therapy (radical prostatectomy or external beam radiotherapy) for localized disease (pT1c—T3b pN0-1 cM0) were included. Results 37 out of 51 patients (72.5%) had positive 68Ga-PSMA-11 PET/CT scans. Age at diagnosis, Gleason score (GS), D’Amico risk status of PCa, initial PSA level before treatment and PSA doubling time were not associated with PSMA positivity. Pre-scan PSA levels of > 0.2 ng/ml and PSA velocity of ≥ 1 ng/ml/year were significantly associated with increased PSMA positivity, whereas history of androgen deprivation therapy showed a trend towards significance. The optimal cutoffs for distinguishing between positive and negative scans were ≥ 0.71 ng/ml for pre-scan PSA and ≥ 1.22 ng/ml/yr for PSA velocity. In multivariable analysis, log pre-scan PSA and pre-scan PSA level > 0.2 ng/ml remained significant predictors for PSMA positivity, whereas the association of PSA velocity and of ADT was lost. Conclusions In BCR of localized PCa following definitive therapy, pre-scan PSA was strongly associated with positive 68GaPSMA-11 scan, even at PSA levels ranging from 0.2 to 1.0 ng/ml. Therefore, clinical and pathological predictors of positive 68 Ga-PSMA-11 PET/CT in PSA-only recurrence of localized prostate cancer need to be further elucidated. Keywords Prostate cancer · 68Ga-PSMA · PET/CT · Neoplasm recurrence · Prostate-specific antigen
Introduction Prostate cancer (PCa) is the second most common malignancy and the fifth leading cause of death from cancer in men [1]. Monitoring with prostate-specific antigen (PSA) following definitive therapy has provided better risk stratification and improved oncologic outcomes in PCa [2, 3]. However, increased PSA levels after definitive therapy is associated with local recurrence and distant metastasis, and it usually precedes metastatic progression [4]. The utility of conventional imaging modalities such as bone scan and * Sertac Yazici [email protected] 1
Department of Urology, School of Medicine, Hacettepe University, Sihhiye, Ankara 06100, Turkey
abdominal computed tomography at PSA-only increase is very limited, especially in asymptomatic patients or at low PSA levels. Prostate-specific membrane antigen
Data Loading...
