Gallium-68 prostate-specific membrane antigen PET-CT and the clinical management of prostate cancer
| Autor: | Elinor Goshen, Adam Lee Goldstein, Raanan Berger, Yaacov Richard Lawrence, Jeffrey Goldstein, Noam Weizman, Zvi Symon, Tima Davidson, Bar Chikman, Uri Amit, Maia Hahiashvili, Simona Ben-Haim, Orith Portnoy, Akram Saad, Zohar A. Dotan, Igor Sadetsky |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Urology Salvage therapy Standardized uptake value Gallium Radioisotopes urologic and male genital diseases 030218 nuclear medicine & medical imaging Management of prostate cancer 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Positron Emission Tomography Computed Tomography medicine Organometallic Compounds Humans Radiology Nuclear Medicine and imaging Neoplasm Metastasis Gallium Isotopes Aged Neoplasm Staging Retrospective Studies PET-CT Membrane Glycoproteins business.industry Cancer Prostatic Neoplasms Retrospective cohort study General Medicine medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis business |
| Zdroj: | Nuclear medicine communications. 40(9) |
| ISSN: | 1473-5628 |
| Popis: | Objectives The purpose of this study was to evaluate the use of Gallium-68 prostatic-specific membrane antigen (PSMA) PET-computerized tomography (CT) in patients with prostate cancer undergoing imaging for initial staging, biochemical failure or the evaluation of metastatic disease. Methods This is a single institution retrospective study of 95 patients with prostate cancer who were referred for PSMA PET-CT scans. The National Comprehensive Cancer Network guidelines were used to generate treatment recommendations. Univariate and multivariate statistical analyses were performed to identify parameters associated with positive findings on a PET-CT PSMA scan. Results Mean age, Gleason score, and median prostate serum antigen (PSA) were: 72 years, 7.6 and 4 ng/ml, respectively. PSMA PET-CT was positive in 75.5% of the patients. A maximum standardized uptake value was 10.7 ± 8.8. PSMA avidity increased with rising PSA level: PSA ≤ 1 ng/ml: 5/15 patients (33%); PSA 1-5 ng/ml: 18/27 patients (67%), and PSA ≥ 5 ng/ml: 33/34 patients (97%). Following imaging in nine high-risk patients referred for staging, changes in treatment occurred in 6 (67%). Treatment recommendations changed in 27/35 (65%) patients referred due to biochemical failure; these included recurrences suitable for salvage therapy (n = 14), metastatic disease not suitable for salvage therapy (n = 10), and no lesion (n = 17). No changes in treatment occurred in any of the 35 patients referred to evaluate metastatic disease. Discussion PSMA PET-CT imaging may have a substantial impact on clinical management in prostate cancer patients at the time of initial staging or with biochemical failure; yet this modality does not appear useful in the management of patients with known metastatic disease. |
| Databáze: | OpenAIRE |
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