MP53-08 THE DIAGNOSTIC VALUE OF 68GA-LABELLED PSMA-LIGAND PET/CT IN MEN WITH RECURRENT PROSTATE CANCER

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You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2015MP53-08 THE DIAGNOSTIC VALUE OF 68GA-LABELLED PSMA-LIGAND PET/CT IN MEN WITH RECURRENT PROSTATE CANCER Boris Hadaschik, Ali Afshar-Oromieh, Jan Radtke, Silvan Boxler, Matthias Eder, Klaus Kopka, Jürgen Debus, Markus Hohenfellner, and Uwe Haberkorn Boris HadaschikBoris Hadaschik More articles by this author , Ali Afshar-OromiehAli Afshar-Oromieh More articles by this author , Jan RadtkeJan Radtke More articles by this author , Silvan BoxlerSilvan Boxler More articles by this author , Matthias EderMatthias Eder More articles by this author , Klaus KopkaKlaus Kopka More articles by this author , Jürgen DebusJürgen Debus More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , and Uwe HaberkornUwe Haberkorn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1702AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES One of the key challenges in the management of men with recurrent prostate cancer (PCa) is early detection. Although choline-based PET/CT is widely used for this purpose, there have been numerous studies reporting a low sensitivity and specificity, especially at low PSA levels. Thus, the development of new and improved imaging methods is required. In this context, the prostate-specific membrane antigen (PSMA) has recently received increased attention. A 68Ga-labelled PSMA-targeted radioligand developed by our group (68Ga-PSMA-HBED-CC) has shown promising results and significantly improved contrast when compared to choline PET/CT. However, published data exist for small patient numbers only. The aim of this evaluation was to analyze the diagnostic value of 68Ga-PSMA-PET/CT in a large cohort. METHODS We performed a retrospective analysis of 319 men who received a 68Ga-PSMA-PET/CT from 2011 to 2014. The effects of several possibly interacting variables such as PSA level and doubling-time (PSA-DT), Gleason score (GS), and androgen deprivation therapy (ADT) were evaluated. Tracer uptake was measured in 901 representative tumor lesions. 42 patients underwent histological verification after 68Ga-PSMA-PET/CT. RESULTS In 82.8% of patients at least one lesion indicative for PCa was detected. Tumor-detection was positively associated with PSA level and ADT, but neither GS nor PSA-DT. Mean SUVmax of tumor lesions was 13.3 ± 14.6 (0.7 – 122.5). Amongst men investigated by histology, 416 lesions were true-positive (n=98) or true-negative (n=318). One local relapse and 29 lymph nodes were false-negative. With regard to the lymph nodes, PET-positive lesions lead to systematic node dissection where additional small lymph node metastases were found. These PET-negative lesions were located in the same region as the PET-positive nodes. A lesion-based analysis of sensitivity, specificity, NPV and PPV revealed values of 76.6%, 100%, 91.4% and 100%. Among 116 patients who were available for follow-up, 50 (40%) were treated locally after 68Ga-PSMA-PET/CT and thereby delayed systemic therapy: 27 were treated with external radiation; 19 underwent surgery and four were treated by HIFU. CONCLUSIONS 68Ga-PSMA-PET/CT can detect recurrent PCa in a high number of patients. Our radiotracer is highly specific for PCa and false positive lesions could not be detected. Detection of PCa is improved at higher PSA levels. Interestingly, also ADT had a significantly positive influence on tumor detection rates. Potentially, 68Ga-PSMA-PET/CT can help delay palliative systemic therapy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e638 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Boris Hadaschik More articles by this author Ali Afshar-Oromieh More articles by this author Jan Radtke More articles by this author Silvan Boxler More articles by this author Matthias Eder More articles by this author Klaus Kopka More articles by this author Jürgen Debus More articles by this author Markus Hohenfellner More articles by this author Uwe Haberkorn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...