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Extent of disease in recurrent prostate cancer determined by 68GaPSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score
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Extent of disease in recurrent prostate cancer determined by 68GaPSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score
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Extent of disease in recurrent prostate cancer determined by 68GaPSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score
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Journal Article
Extent of disease in recurrent prostate cancer determined by 68GaPSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score
2016
Overview
Purpose
To examine the relationship between the extent of disease determined by [
68
Ga]PSMA-HBED-CC-PET/CT and the important clinical measures prostate-specific antigen (PSA), PSA doubling time (PSAdt) and Gleason score.
Methods
We retrospectively studied the first 155 patients with recurrent prostate cancer (PCA) referred to our university hospital for [
68
Ga]PSMA-HBED-CC PET/CT.
Results
PET/CT was positive in 44 %, 79 % and 89 % of patients with PSA levels of ≤1, 1 – 2 and ≥2 ng/ml, respectively. Patients with high PSA levels showed higher rates of local prostate tumours (
p
< 0.001), and extrapelvic lymph node (
p
= 0.037) and bone metastases (
p
= 0.013). A shorter PSAdt was significantly associated with pelvic lymph node (
p
= 0.026), extrapelvic lymph node (
p
= 0.001), bone (
p
< 0.001) and visceral (
p
= 0.041) metastases. A high Gleason score was associated with more frequent pelvic lymph node metastases (
p
= 0.039). In multivariate analysis, both PSA and PSAdt were independent determinants of scan positivity and of extrapelvic lymph node metastases. PSAdt was the only independent marker of bone metastases (
p
= 0.001). Of 20 patients with a PSAdt <6 months and a PSA ≥2 ng/ml, 19 (95 %) had a positive scan and 12 (60 %) had M1a disease. Of 14 patients with PSA <1 ng/ml and PSAdt >6 months, only 5 (36 %) had a positive scan and 1 (7 %) had M1a disease.
Conclusion
[
68
Ga]PSMA-HBED-CC PET/CT will identify PCA lesions even in patients with very low PSA levels. Higher PSA levels and shorter PSAdt are independently associated with scan positivity and extrapelvic metastases, and can be used for patient selection for [
68
Ga]PSMA-HBED-CC PET/CT.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Aged
/ Antigens
/ Antigens, Surface - chemistry
/ Edetic Acid - analogs & derivatives
/ Gallium Radioisotopes - chemistry
/ Glutamate Carboxypeptidase II - chemistry
/ Humans
/ Imaging
/ Male
/ Medicine
/ Neoplasm Recurrence, Local - blood
/ Neoplasm Recurrence, Local - diagnostic imaging
/ Neoplasm Recurrence, Local - pathology
/ Oncology
/ Positron-Emission Tomography
/ Prostate-Specific Antigen - blood
/ Prostatic Neoplasms - diagnostic imaging
