68Ga-PSMA-PET/CT in Patients With Biochemical Prostate Cancer Recurrence and Negative 18F-Choline-PET/CT.

Abstract

PURPOSE:

Investigating the value of Ga-PSMA-PET/CT in biochemically recurring prostate cancer patients with negative F-choline-PET/CT.

PATIENTS AND METHODS:

One hundred thirty-nine consecutive patients with biochemical recurrence after curative (surgery and/or radiotherapy) therapy were offered participation in this sequential clinical imaging approach. Patients first underwent an F-choline-PET/CT. If negative, an additional Ga-PSMA-PET/CT was offered. One hundred twenty-five of 139 eligible patients were included in the study; 32 patients underwent additional Ga-PSMA-PET/CT. Patients with equivocal findings (n = 5) on F-choline-PET/CT and those who declined the additional Ga-PSMA-PET/CT (n = 9) were excluded. Images were analyzed visually for the presence of suspicious lesions. Findings on PET/CT were correlated with PSA level, PSA doubling time (dt), and PSA velocity (vel).

RESULTS:

The overall detection rates were 85.6% (107/125) for the sequential imaging approach and 74.4% (93/125) for F-choline-PET/CT alone. Ga-PSMA-PET/CT detected sites of recurrence in 43.8% (14/32) of the choline-negative patients. Detection rates of the sequential imaging approach and F-choline-PET/CT alone increased with higher serum PSA levels and PSA vel. Subgroup analysis of Ga-PSMA-PET/CT in F-choline negative patients revealed detection rates of 28.6%, 45.5%, and 71.4% for PSA levels of 0.2 or greater to less than 1 ng/mL, 1 to 2 ng/mL, and greater than 2 ng/mL, respectively.

CONCLUSIONS:

The sequential imaging approach designed to limit Ga-PSMA imaging to patients with negative choline scans resulted in high detection rates. Ga-PSMA-PET/CT identified sites of recurrent disease in 43.8% of the patients with negative F-choline PET/CT scans.

• Authors: Christina Bluemel, Markus Krebs, Bülent Polat, Fränze Linke, Matthias Eiber, Samuel Samnick, Constantin Lapa, Michael Lassmann, Hubertus Riedmiller, Johannes Czernin, Domenico Rubello, Thorsten Bley, Saskia Kropf, Hans-Juergen Wester, Andreas K Buck, Ken Herrmann
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 41 Issue 7 Pg. 515-21 (Jul 2016) ISSN: 1536-0229 [Electronic] United States
• PMID: 26975008 (Publication Type: Journal Article)

Chemical References

• Antigens, Surface
• Gallium Radioisotopes
• fluoromethylcholine
• FOLH1 protein, human
• Glutamate Carboxypeptidase II
• Choline

Topics

• Aged
• Aged, 80 and over
• Antigens, Surface
• Choline (analogs & derivatives)
• Gallium Radioisotopes (metabolism)
• Glutamate Carboxypeptidase II
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnostic imaging)
• Positron Emission Tomography Computed Tomography (methods)
• Prostatic Neoplasms (diagnostic imaging, metabolism, pathology)