A Prospective Study on [68Ga]-PSMA PET/CT Imaging in Newly Diagnosed Intermediate- and High-Risk Prostate Cancer | ||
| Asia Oceania Journal of Nuclear Medicine and Biology | ||
| مقاله 2، دوره 9، شماره 2، مهر 2021، صفحه 101-110 اصل مقاله (1.05 M) | ||
| نوع مقاله: Original Article | ||
| شناسه دیجیتال (DOI): 10.22038/aojnmb.2020.52375.1358 | ||
| نویسندگان | ||
| Sara Harsini1، 2؛ Babak Fallahi1؛ Najme Karamzade ziarati1؛ Ali Razi3؛ Erfan Amini4؛ Alireza Emami Ardekani1؛ Armaghan Fard Esfehani1؛ Mehdi Kardoust Parizi5؛ saeed farzanehfar6؛ Davood Beiki* 1 | ||
| 1Research Center for Nuclear Medicine, Tehran University of Medical sciences, Tehran, Iran | ||
| 2Association of Nuclear Medicine and Molecular Imaging (ANMMI), Universal Scientific Education and Research Network (USERN), Tehran, Iran | ||
| 3Department of Urology, Tehran University of Medical Sciences, Tehran, Iran | ||
| 4Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran | ||
| 5Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
| 6Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
| چکیده | ||
| Objective(s): Prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) is an emerging modality to detect metastatic disease in patients with prostate cancer (PCa). This prospective study aimed to evaluate the role of [68Ga]-PSMA PET/CT in the initial workup of intermediate and high-risk PCa . Methods: Twenty-five patients with newly transrectal ultrasound biopsy-proven, untreated intermediate- and high-risk PCa (mean age, 68.5±6.2 years; range 55–83 years) were enrolled in this prospective study between September 2018 and June 2020 and underwent a [68Ga]-PSMA PET/CT examination. All images were analyzed both visually and semiquantitatively by measuring the maximum standardized uptake value (SUVmax) of the primary prostatic tumor and metastatic lesions. The diagnostic sensitivity of [68Ga]-PSMA PET/CT for the diagnosis of PCa was established by histopathology as the reference standard. The associations between SUVmax of the primary tumors and prostate-specific antigen (PSA) levels, Gleason scores (GSs), and metastatic extent of the disease were studied. Results: All patients had a positive [68Ga]-PSMA PET/CT exam. Seventeen patients (58%) showed [68Ga]-PSMA avidity in both prostate lobes and 8 (32%) had unilateral uptake. SUVmax in the primary tumor significantly correlated with serum PSA values (r=0.57, P=0.003). PSMA PET/CT depicted regional lymph node metastases in 32% of patients, distant lymph node metastases in 20%, osseous metastases in 16% and pulmonary metastases in 8% of patients. Sixty percent of PSMA-positive bone metastases and 21.4% of intraprostatic tumoral lesions were missed on the contemporaneous bone scintigraphy and magnetic resonance imaging, respectively. Conclusion: [68Ga]-PSMA PET/CT shows promise as a valuable imaging modality with high diagnostic sensitivity in the setting of intermediate and high-risk PCa. Moreover, the SUVmax of the primary tumor has a positive correlation with PSA levels at the time of the scan. | ||
| کلیدواژهها | ||
| Prostate cancer؛ PSMA PET/CT؛ Primary staging | ||
| مراجع | ||
|
1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: a cancer journal for clinicians. 2019; 69(1):7-34.
2. Eggener SE, Scardino PT, Walsh PC, Han M, Partin AW, Trock BJ, et al. Predicting 15-year prostate cancer specific mortality after radical prostatectomy. J Urol. 2011; 185(3):869-75.
3. Zumsteg ZS, Spratt DE, Romesser PB, Pei X, Zhang Z, Polkinghorn W, et al. The natural history and predictors of outcome following biochemical relapse in the dose escalation era for prostate cancer patients undergoing definitive external beam radiotherapy. Eur Urol. 2015; 67(6):1009-16.
4. Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. Prostate cancer, version 2.2019, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2019; 17(5): 479-505.
5. Briganti A, Abdollah F, Nini A, Suardi N, Gallina A, Capitanio U, et al. Performance characteristics of computed tomography in detecting lymph node metastases in contemporary patients with prostate cancer treated with extended pelvic lymph node dissection. European urology. 2012; 61(6): 1132-8.
6. Calais J, Ceci F, Eiber M, Hope TA, Hofman MS, Rischpler C, et al. 18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial. The Lancet Oncology. 2019; 20(9):1286-94.
7. Roach PJ, Francis R, Emmett L, Hsiao E, Kneebone A, Hruby G, et al. The impact of 68Ga-PSMA PET/CT on management intent in prostate cancer: results of an Australian prospective multicenter study. Journal of Nuclear Medicine. 2018; 59(1):82-8.
8. Afshar-Oromieh A, Holland-Letz T, Giesel FL, Kratochwil C, Mier W, Haufe S, et al. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. European journal of nuclear medicine and molecular imaging. 2017; 44(8):1258-68.
9. Fendler WP, Calais J, Eiber M, Flavell RR, Mishoe A, Feng FY, et al. Assessment of 68Ga-PSMA-11 PET accuracy in localizing recurrent prostate cancer: a prospective single-arm clinical trial. JAMA oncology. 2019; 5(6):856-63.
10. Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I, et al. Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer-Updated Diagnostic Utility, Sensitivity, Specificity, and Distribution of Prostate-specific Membrane Antigen-avid Lesions: A Systematic Review and Meta-analysis. Eur Urol. 2020; 77(4):403-17.
11. Maurer T, Gschwend JE, Rauscher I, Souvatzoglou M, Haller B, Weirich G, et al. Diagnostic efficacy of 68gallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer. The Journal of urology. 2016; 195(5):1436-43.
12. Ferraro DA, Schüler HIG, Muehlematter UJ, Eberli D, Müller J, Müller A, et al. Impact of 68 Ga-PSMA-11 PET staging on clinical decision-making in patients with intermediate or high-risk prostate cancer. European Journal of Nuclear Medicine and Molecular Imaging. 2020; 47(3):652-64.
13. Yaxley JW, Raveenthiran S, Nouhaud FX, Samaratunga H, Yaxley WJ, Coughlin G, et al. Risk of metastatic disease on 68gallium‐prostate‐specific membrane antigen positron emission tomography/computed tomography scan for primary staging of 1253 men at the diagnosis of prostate cancer. BJU international. 2019; 124(3):401-7.
14. Van Leeuwen PJ, Emmett L, Ho B, Delprado W, Ting F, Nguyen Q, et al. Prospective evaluation
of 68Gallium‐prostate‐specific membrane antigen positron emission tomography/ computed tomography for preoperative lymph node staging in prostate cancer. BJU international. 2017; 119(2):209-15.
15. D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. Jama. 1998; 280(11):969-74.
16. Fanti S, Minozzi S, Morigi JJ, Giesel F, Ceci F, Uprimny C, et al. Development of standardized image interpretation for 68Ga-PSMA PET/CT to detect prostate cancer recurrent lesions. Eur J Nucl Med Mol Imaging. 2017; 44(10):1622-35.
17. Berger I, Annabattula C, Lewis J, Shetty D, Kam J, Maclean F, et al. 68Ga-PSMA PET/CT vs. mpMRI for locoregional prostate cancer staging: correlation with final histopathology. Prostate cancer and prostatic diseases. 2018; 21(2):204-11.
18. Sachpekidis C, Kopka K, Eder M, Hadaschik BA, Freitag MT, Pan L, et al. 68Ga-PSMA-11 dynamic PET/CT imaging in primary prostate cancer. Clinical nuclear medicine. 2016; 41(11):e473-e9.
19. Budäus L, Leyh-Bannurah S-R, Salomon G, Michl U, Heinzer H, Huland H, et al. Initial experience of 68Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy. European urology. 2016; 69(3):393-6.
20. Kabasakal L, Demirci E, Ocak M, Akyel R, Nematyazar J, Aygun A, et al. Evaluation of PSMA PET/CT imaging using a 68Ga-HBED-CC ligand in patients with prostate cancer and the value of early pelvic imaging. Nuclear medicine communications. 2015; 36(6):582-7.
21. Rahbar K, Weckesser M, Huss S, Semjonow A, Breyholz H-J, Schrader AJ, et al. Correlation of intraprostatic tumor extent with 68Ga-PSMA distribution in patients with prostate cancer. Journal of Nuclear Medicine. 2016; 57(4):563-7.
22. Kallur KG, Ramachandra PG, Rajkumar K, Swamy SS, Desai I, Rao RM, et al. Clinical utility of gallium-68 PSMA PET/CT scan for prostate cancer. Indian journal of nuclear medicine: IJNM: the official journal of the Society of Nuclear Medicine, India. 2017; 32(2):110.
23. Basha MAA, Hamed MAG, Hussein O, El-Diasty T, Abdelkhalek YI, Hussein YO, et al. 68Ga-PSMA-11 PET/CT in newly diagnosed prostate cancer: diagnostic sensitivity and interobserver agreement. Abdominal Radiology. 2019; 44(7):2545-56.
24. Hedva Lerman M, Charles Levine M, Barnes S. 68Ga-PSMA PET/CT Staging of Newly Diagnosed Intermediate-and High-Risk Prostate Cancer.
25. Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I, et al. Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer—updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: a systematic review and meta-analysis. European urology. 2020; 77(4):403-17.
26. Kuten J, Mabjeesh NJ, Lerman H, Levine C, Barnes S, Even-Sapir E. Ga-PSMA PET/CT Staging of Newly Diagnosed Intermediate-and High-Risk Prostate Cancer. The Israel Medical Association journal: IMAJ. 2019; 21(2):100-4.
27. Fendler WP, Schmidt DF, Wenter V, Thierfelder KM, Zach C, Stief C, et al. 68Ga-PSMA PET/CT detects the location and extent of primary prostate cancer. Journal of Nuclear Medicine. 2016; 57(11):1720-5.
28. Uprimny C, Kroiss AS, Decristoforo C, Fritz J, von Guggenberg E, Kendler D, et al. 68Ga-PSMA-11 PET/CT in primary staging of prostate cancer: PSA and Gleason score predict the intensity of tracer accumulation in the primary tumour. European journal of nuclear medicine and molecular imaging. 2017; 44(6):941-9.
29. Han S, Woo S, Kim YJ, Suh CH. Impact of 68Ga-PSMA PET on the management of patients with prostate cancer: a systematic review and meta-analysis. European urology. 2018; 74(2):179-90.
30. Hofman MS, Lawrentschuk N, Francis RJ, Tang C, Vela I, Thomas P, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multi-centre study. The Lancet. 2020.
31. Herlemann A, Wenter V, Kretschmer A, Thierfelder KM, Bartenstein P, Faber C, et al. 68Ga-PSMA positron emission tomography/ computed tomography provides accurate staging of lymph node regions prior to lymph node dissection in patients with prostate cancer. European urology. 2016; 70(4):553-7.
32. Pyka T, Okamoto S, Dahlbender M, Tauber R, Retz M, Heck M, et al. Comparison of bone scintigraphy and 68Ga-PSMA PET for skeletal staging in prostate cancer. European journal of nuclear medicine and molecular imaging. 2016; 43(12):2114-21. | ||
|
آمار تعداد مشاهده مقاله: 1,668 تعداد دریافت فایل اصل مقاله: 788 |
||