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22.11.2019 | Research Article

Application of [⁶⁸Ga]PSMA PET/CT in Diagnosis and Management of Prostate Cancer Patients

verfasst von: Habibollah Dadgar, Farshad Emami, Nasim Norouzbeigi, Manouchehr Seyedi Vafaee, Esmail Jafari, Ali Gholamrezanezhad, Majid Assadi, Hojjat Ahmadzadehfar

Erschienen in: Molecular Imaging and Biology | Ausgabe 4/2020

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Abstract

Purpose

The early and accurate diagnosis of locoregional recurrence or metastasis in prostate cancer (PC) has a significant impact on treatment options. Prostatic-specific membrane antigen (PSMA) positron emission tomography (PET)/x-ray computed tomograph (CT) imaging has recently been introduced as a novel procedure in managing PC. The aim of this study was to evaluate the efficacy of [⁶⁸Ga]PSMA PET/CT in managing PC patients and to compare the detection rate of PET/CT and bone scans (BSs) in detecting bone metastasis.

Procedures

We evaluated 415 patients with PC who underwent [⁶⁸Ga]PSMA PET/CT between March 2015 and September 2018. The patients were classified into three groups: staging, biomedical recurrence (BCR), and follow-up or monitoring, based on the intent to perform PET/CT.

Results

We evaluated 415 patients aged 41–99 (68.25 ± 9.59). Of these patients, 344 (82.9 %) had at least one localized lesion. The detection rates were 48.3 %, 52.6 %, 74.4 %, 79.6 %, and 93.9 % for a PSA value of < 0.2 ng/ml, ≥ 0.2–< 0.5 ng/ml, ≥ 0.5–< 1 ng/ml, ≥ 1–< 2 ng/ml, and ≥ 2 ng/ml, respectively (p < 0.05). The detection rates increased significantly with higher GSs; the rates were 68.3 % (28/41), 74.5 % (73/98), 93.9 % (46/49), and 91 % (61/67) for a GS of < 7, 7, 8, and > 8, respectively (p < 0.05). An ideal cut-off value of > 1.16 ng/ml was obtained for PSA value, which equates to specificity of 75 % and sensitivity of 77 %. In comparing BSs and PET/CT, a region-based analysis showed the superiority of PET/CT over BSs for all regions expect the skull (p < 0.05). PET/CT detected 258 suspicious regions, 255 of which were metastatic and three of which were equivocal. BSs detected only 223 suspicious regions, 203 of which were metastatic and 20 of which were equivocal.

Conclusions

[⁶⁸Ga]PSMA PET/CT showed a high detection rate for lesions in PC patients. PSA level, GS, and a PSA doubling time of less than 6 months were shown to be the affective variables. In addition, ⁶⁸Ga-PSMA PET/CT showed better performance in detecting bone lesions than BSs.

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Titel: Application of [68Ga]PSMA PET/CT in Diagnosis and Management of Prostate Cancer Patients
verfasst von: Habibollah Dadgar
Farshad Emami
Nasim Norouzbeigi
Manouchehr Seyedi Vafaee
Esmail Jafari
Ali Gholamrezanezhad
Majid Assadi
Hojjat Ahmadzadehfar
Publikationsdatum: 22.11.2019
Verlag: Springer International Publishing
Erschienen in: Molecular Imaging and Biology / Ausgabe 4/2020
Print ISSN: 1536-1632
Elektronische ISSN: 1860-2002
DOI: https://doi.org/10.1007/s11307-019-01445-z

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Application of [⁶⁸Ga]PSMA PET/CT in Diagnosis and Management of Prostate Cancer Patients