Diagnostic performance of 68GA-PSMA PET/CTin patients with prostate cancer


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Abstract

Introduction and aim. Most of the patients with biochemical recurrence after radical prostatectomy undergo salvage radiotherapy without guidance from imaging. In recent years, there has been an increasing role of Gallium-68 prostate specific membrane antigen (68Ga-PSMA) positron emission tomography/computed tomography (PET/CT) imaging in the management of prostate cancer. This study aimed to investigate diagnostic performance of 68Ga-PSMA PET/CT in patients with biochemical recurrence after radical prostatectomy. Materials and methods. From 2016 to 2017, 19 prostate cancer patients were evaluated by 68Ga-PSMA PET/CT at the Urology Clinic of S.P Botkin City Clinical Hospital; 17 of them had a biochemical recurrence and needed restaging of the disease. The age, prostate specific antigen (PSA) values, therapy at the time of the study, and maximum standard uptake value (SUVmax) were evaluated. Results. The median age of patients was 65 years (interquartile range (IQR) 58.5-70.5), the median total PSA level was 2.36 ng/mL (IQR 1.5-4.19). In 8 of 17 patients, the PSA values did not exceed 2 ng/ml. The median time after radical prostatectomy was 33.2 months. (IQR 12-54.5). Positive PET/CT sites of recurrence were detected in 15 of 17 patients. Nine patients had only one positive site, and in six patients several positive sites were detected. Four patients with PET/CT positive pelvic lymph nodes and/or retroperitoneal space underwent salvage lymphadenectomy. Histological findings confirmed the presence of malignant growth in 3 out of 4 cases. Conclusion. 68Ga-PSMA PET/CT is an effective tool for the early detection of oligometastatic lesions in recurrent prostate cancer.

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About the authors

E. I Veliev

S.P Botkin City Clinical Hospital; RMACPE

Email: veliev@urotop.ru
Dr.Med.Sci., Prof., Head of the Urological Department #14; Prof. at the Department of Urology and Surgical Andrology

A. A Tomilov

S.P Botkin City Clinical Hospital

Email: toandrei33@yandex.ru
Ph.D., Urologist at the Urological Department #14

D. A Goncharuk

RMACPE

Email: doctor-krug@yandex.ru
Ph.D. Student at the Department of Urology and Surgical Andrology

A. B Bogdanov

S.P Botkin City Clinical Hospital; RMACPE

Email: abbogdanov@hotmail.com
Ph.D., Urologist at the Urological Department #14

E. N Golubtsova

S.P Botkin City Clinical Hospital; RMACPE

Email: engolubtsova@yandex.ru
Ph.D., Urologist at the Urological Department #14

References

  1. Злокачественные новообразования в России в 2015 году. Заболеваемость и смертность. Ред. А.Д. Каприн, В.В. Старинский, Г.В. Петрова. М.: МНИОИ им. П.А. Герцена -филиал ФГБУ «НМИРЦ» Минздрава России. 2017; 250 с.
  2. Freedland S.J., Presti J.C. Jr, Amling C.L., Kane C.J., Aronson W.J., Dorey F., Terris M.K. Time trends in biochemical recurrence after radical prostatectomy: results of the SEARCH database. Urology. 2003;61:736-741.
  3. Hijazi S., Meller B., Leitsmann C., Strauss A., Meller J., Ritter C.O., Lotz J., Schildhaus H.U., Trojan L., Sahlmann C.O. Pelvic lymph node dissection for nodal oligometastatic prostate cancer detected by 68Ga-PSMA-positron emission tomography/computerized tomography, Prostate. 2015;75(16):1934-1940. doi: 10.1002/pros.23091.
  4. European Association of Urology prostate cancer guidelines. http:// uroweb.org/guideline/prostate-cancer/ (электронный ресурс).
  5. Morigi J.J., Stricker P.D., van Leeuwen P.J., Tang R., Ho B., Nguyen Q., Hruby G., Fogarty G., Jagavkar R., Kneebone A., Hickey A., Fanti S., Tarlinton L., Emmett L. Prospective Comparison of 18F-Fluoromethylcholine Versus 68Ga-PSMA PET/CT in Prostate Cancer Patients Who Have Rising PSA After Curative Treatment and Are Being Considered for Targeted Therapy. J. Nucl Med. 2015;56:1185-1190. doi: 10.2967/jnumed.115.160382.
  6. Afshar-Oromieh A., Zechmann C.M., Malcher A., Eder M., Eisenhut M., Linhart H.G., Holland-Letz T., Hadaschik B.A., Giesel F.L., Debus J., Haberkorn U. Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J. Nucl Med Mol Imaging. 2014;41:11- 20. doi: 10.1007/s00259-013-2525-5.
  7. Eiber M., Maurer T., Souvatzoglou M., Beer A.J., Ruffani A., Haller B., Graner F.P., Kübler H., Haberkorn U., Eisenhut M., Wester H.J., Gschwend J.E., Schwaiger M. Evaluation of Hybrid “Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy. J. Nucl Med. 2015;56(5):668-674. Doi: 10.2967/ jnumed.115.154153.
  8. Silver D.A., Pellicer I., Fair W.R., Heston W.D., Cordon-Cardo C. Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res. 1997;3:81-85.
  9. Ghosh A., Heston W. Tumor target prostate specific membrane antigen (PSMA) and its regulation in prostate cancer. J. Cell Biochem. 2004;91:528-539.
  10. Ceci F., Herrmann K., Castellucci P., Graziani T., Bluemel C., Schiavina R., Vollmer C., Droll S., Brunocilla E., Mazzarotto R., Buck A.K., Fanti S. Impact of 11C-choline PET/CT on clinical decision making in recurrent prostate cancer: results from a retrospective two-centre trial. Eur J. Nucl Med Mol Imaging. 2014;41:2222-2231. Doi: 10.1007/ s00259-014-2872-x.
  11. Fuccio C., Rubello D., Castellucci P., Marzola M.C., Fanti S. Choline PET/CT for prostate cancer: main clinical applications. Eur J. Radiol. 2011;80:50-56. doi: 10.1016/j.ejrad.2010.07.023.
  12. Bauman G., Belhocine T., Kovacs M., Ward A., Beheshti M., Rachinsky I. 18F-fluorocholine for prostate cancer imaging: a systematic review of the literature. Prostate Cancer Prostatic Dis. 2011;15:45-55. Doi: 10.1038/ pcan.2011.35.
  13. Ceci F., Castellucci P., Cerci J., Fanti S. New aspects of molecular imaging in prostate cancer. Methods. 2017;130:36-41. Doi: 10.1016/j. ymeth.2017.07.009.
  14. Afshar-Oromieh A., Avtzi E., Giesel F.L., Holland-Letz T., Linhart H.G., Eder M., Eisenhut M., Boxler S., Hadaschik B.A., Kratochwil C., Weichert W., Kopka K., Debus J., Haberkorn U. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis ofrecurrent prostate cancer. Eur J. Nucl Med Mol Imaging. 2015;42(2):197-209. doi: 10.1007/s00259-014-2949-6.
  15. von Eyben F.E., Picchio M., von Eyben R., Rhee H., Bauman G. 68Ga-Labeled Prostate-specific Membrane Antigen Ligand Positron Emission Tomography/Computed Tomography for Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Focus. 2016 Nov doi: 10.1016/j.euf.2016.11.002.
  16. Hövels A.M., Heesakkers R.A., Adang E.M., Jager G.J., Strum S., Hoogeveen Y.L., Severens J.L., Barentsz J.O. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol. 2008;63:387-395. doi: 10.1016/j.crad.2007.05.022.
  17. Thoeny H.C., Barbieri S., Froehlich J.M., Turkbey B., Choyke P.L. Functional and targeted lymph node imaging in prostate cancer: current status and future challenges. Radiology 2017;285:728-743. doi: 10.1148/radiol.2017161517.
  18. Maurer T., Gschwend J.E., Rauscher I., Souvatzoglou M., Haller B., Weirich G., Wester H.J., Heck M., Kübler H., Beer A.J., Schwaiger M., Eiber M. Diagnostic Efficacy of (68)GaUium-PSMA Positron Emission Tomography Compared to Conventional Imaging for Lymph Node Staging of 130 Consecutive Patients with Intermediate to High Risk Prostate Cancer. J. Urol. 2016;195(5):1436-1443. Doi: 10.1016/j. juro.2015.12.025.
  19. Bouchelouche K., Choyke P. Prostate-specific membrane antigen positron emission tomography in prostate cancer: a step toward personalized medicine. Curr Opin Oncol 2016;28:216-221. doi: 10.1097/CC0.0000000000000277.
  20. Michaud L., Touijer K. Molecular imaging for prostate cancer: performance analysis of 68Ga-PSMA PET/CT versus choline PET/CT. Actas Urol Esp. 2017;41:292-299. doi: 10.1016/j.acuro.2016.09.015.
  21. Schwenck J., Rempp H., Reischl G., Kruck S., Stenzl A., Nikolaou K., Pfannenberg C., la Fougère C. Comparison of 68Ga-labelled PSMA-11 and (11)C-choline in the detection of prostate cancer metastases by PET/CT. Eur J. Nucl Med Mol Imaging. 2017;44:92-101.
  22. Heidenreich A., Bastian P.J., Bellmunt J., Bolla M., Joniau S., van der Kwast T., Mason M., Matveev V., Wiegel T., Zattoni F., Mottet N. EAU guidelines on prostate cancer. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2014;65:467-479. doi: 10.1016/j.eururo.2013.11.002.
  23. Perera M., Papa N., Christidis D., Wetherell D., Hofman M.S., Murphy D.G., Bolton D., Lawrentschuk N. Sensitivity, specificity, and predictors of positive 68Ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: a systematic review and metaanalysis. Eur Urol. 2016;70:926-937. Doi: 10.1016/j. eururo.2016.06.021.
  24. Afshar-Oromieh A., Holland-Letz T., Giesel F.L., Kratochwil C., Mier W., Haufe S., Debus N., Eder M., Eisenhut M., Schäfer M., Neels O., Hohenfellner M., Kopka K., Kauczor H.U., Debus J., Haberkorn U. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J. Nucl Med Mol Imaging. 2017;44:1258-1268. doi: 10.1007/s00259-017-3711-7.
  25. Pfister D., Porres D., Heidenreich A., et al. Detection of recurrent prostate cancer lesions before salvage lymphadenectomy is more accurate with 68Ga-PSMA-HBED-CC than with 18F-fluoroethylcho-line PET/CT. Eur J. Nucl Med Mol Imaging 2016;43:1410-1417.
  26. Rauscher I., Maurer T., Beer A.J., Graner F.P., Haller B., Weirich G., Doherty A., Gschwend J.E., Schwaiger M., Eiber M. Value of 68Ga-PSMA HBED-CC PET for the assessment of lymph node metastases in prostate cancer patients with biochemical recurrence: comparison with histopathology after salvage lymphadenectomy. J. Nucl Med 2016;57:1713-1719.
  27. Ceci F., Uprimny C., Nilica B., Geraldo L., Kendler D., Kroiss A., Bektic J., Horninger W., Lukas P., Decristoforo C., Castellucci P., Fanti S., Virgolini I.J. 68Ga-PSMAPET/CT forrestaging recurrentprostate cancer: which factors are associated with PET/CT detection rate? Eur J. Nucl Med Mol Imaging. 2015;42(8):1284-1294. doi: 10.1007/s00259-015-3078-6.
  28. Emmett L., Willowson K., Violet J., Shin J., Blanksby A., Lee J. Lutetium 177 PSMA radionuclide therapy for men with prostate cancer: a review of the current literature and discussion of practical aspects of therapy. J. Med Radiat Sci. 2017; 64(1):52-60. doi: 10.1002/jmrs.227.
  29. Ceci F., Castellucci P., Fanti S. Current application and future perspectives of PSMA PET imaging in prostate cancer. Q. J. Nucl Med Mol Imaging. 2018 Mar 8. doi: 10.23736/S1824-4785.18.03059-5.
  30. van Leeuwen P.J., Emmett L., Ho B., Delprado W., Ting F., Nguyen Q., Stricker P.D. Prospective evaluation of 68Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer. BJU Int. 2017;119(2):209-215. doi: 10.1111/bju.13540.
  31. Afshar-Oromieh A., Sattler L.P., Mier W., Hadaschik B.A., Debus J., Holland-Letz T., Kopka K., Haberkorn U. The Clinical Impact of Additional Late PET/CT Imaging with 68Ga-PSMA in the Diagnosis of Prostate Cancer. J. Nucl Med. 2017;58(5):750-755. Doi: 10.2967/ jnumed.116.183483.
  32. Derlin T., Weiberg D., von Klot C., Wester H.J., Henkenberens C., Ross T.L., Christiansen H., Merseburger A.S., Bengel F.M. Ga-PSMA PET/CT for assessment of prostate cancer: evaluation of image quality after forced diuresis and delayed imaging. Eur Radiol. 2016;26(12):4345-4353.

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