Abstract
68Ga-PSMA-11 positron-emission tomography/computed tomography (PET/CT) is commonly used for restaging recurrent prostate cancer (PC) in European clinical practice. The goal of this study is to determine the optimum time for performing these PET/CT scans in a large cohort of patients by identifying the prostate-specific-antigen (PSA) and PSA kinetics thresholds for detecting and localizing recurrent PC. This retrospective analysis includes 581 patients with biochemical recurrence (BC) by definition. The performance of 68Ga-PSMA-11 PET/CT in relation to the PSA value at the scan time as well as PSA kinetics was assessed by the receiver-operating-characteristic-curve (ROC) generated by plotting sensitivity versus 1-specificity. Malignant prostatic lesions were identified in 77%. For patients that were treated with radical prostatectomy (RP) a PSA value of 1.24 ng/mL was found to be the optimal cutoff level for predicting positive and negative scans, while for patients previously treated with radiotherapy (RT) it was 5.75 ng/mL. In RP-patients with PSA value <1.24 ng/mL, 52% scans were positive, whereas patients with PSA ≥1.24 ng/mL had positive scan results in 87%. RT-patients with PSA <5.75 ng/mL had positive scans in 86% and for those with PSA ≥5.75 ng/mL 94% had positive scans. This study identifies the PSA and PSA kinetics threshold levels for the presence of 68Ga-PSMA-11 PET/CT-detectable PC-lesions in BC patients.
Highlights
Prostate cancer (PC) is the second most common type of malignant cancers and it accounts for 55%of global cancer incidence, together with lung, stomach, and breast cancer [1]
The EAU guidelines report that salvage RT in biochemical recurrence (BC) patients after radical prostatectomy (RP) was correlated with a tripling in PC-specific survival when compared to the patients who did not get salvage therapy [8]
This study identifies the PSA and PSA kinetics thresholds for the presence of 68 Ga-prostate specific membrane antigen (PSMA)-11
Summary
Prostate cancer (PC) is the second most common type of malignant cancers and it accounts for 55%. Of global cancer incidence, together with lung, stomach, and breast cancer [1]. The global incidence of PC in 2012 is 1.1 million per year and accounts for approximately 7% of deaths in men [2]. Cancers 2020, 12, 398 has increased to 95–116 per 10,000 persons and the incidence of death related to PC is 2 per 10,000 per person years since the introduction of prostate-specific-antigen (PSA)-screening [3]. Most patients with BC of PC are diagnosed at an early tumor stage with local disease. The primary treatment of choice for localized PC is radical prostatectomy (RP) or radiation therapy (RT). Several alternative treatment options have been approved, especially for the therapy of aggressive
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