Levent Kabasakal1, Emre Demirci, Jamal Nematyazar, Reşit Akyel, Baresh Razavi, Meltem Ocak, Aslan Aygun, Can Obek, Ali R Kural. 1. aDepartment of Nuclear Medicine, Cerrahpasa Medical Faculty bDepartment of Pharmaceutical Technology, Pharmacy Faculty cDepartment of Urology, Cerrahpasa Medical Faculty, Istanbul University dDepartment of Nuclear Medicine, Sisli Etfal Training and Research Hospital eDepartment of Urology, Acibadem University Medical Faculty, Istanbul, Turkey.
Abstract
INTRODUCTION: Prostate-specific membrane antigen (PSMA) is increasingly being recognized as a novel target for the PET imaging of prostate cancer (PCa) and Ga-DKFZ-11 (Ga-PSMA) has been suggested as a novel tracer for detection of PCa relapses and metastases. The aim of this study was to evaluate the diagnostic value of PSMA PET/CT in the diagnosis of recurrent PCa with low prostate-specific antigen (PSA) levels. PATIENTS AND METHODS: We carried out a retrospective analysis of patients who underwent PSMA PET/CT from November 2013 to December 2014 in our department. Among these patients, 50 out of 178 who had increasing PSA levels (<5 ng/ml) and did not have known metastasis were included in this study. RESULTS: Patients had an average PSA of 1.41 ng/ml. A total of 29 patients (58%) showed at least one positive lesion. PET positivity rates of 31% (n=4), 54% (n=13), and 88% (n=14) were observed in patients with a PSA level of less than 0.2, 0.2-2, and 2-5 ng/ml, respectively. A positive correlation was observed between positivity rate and Gleason scores and blood PSA levels. Verification was performed in 46 patients, with biopsy (n=3) and follow-up, and conventional imaging studies at the time of the PET/CT or during follow-up with a mean period of 10.6±3.3 months and ranged from 3.8 to 16.4 months. According to patient-based analysis of 46 cases, 57% of patients had true positive, 24% of patients had true negative, 2% of patients had false positive, an 18% of patients had false-negative findings. A sensitivity of 76.47% (95% confidence interval: 58.83-89.25%) and a specificity of 91.67% (95% confidence interval: 61.52-99.79%) were found. CONCLUSION: PET/CT with Ga-PSMA is a valuable tool for assessing recurrence of PCa with a high sensitivity in patients who have PSA levels between 0.2 and 5 ng/ml. In addition, this study suggests that PSMA PET/CT can be used in patients with very low (<0.2 ng/ml) but increasing PSA levels, which, in many cases, may influence further clinical management.
INTRODUCTION:Prostate-specific membrane antigen (PSMA) is increasingly being recognized as a novel target for the PET imaging of prostate cancer (PCa) and Ga-DKFZ-11 (Ga-PSMA) has been suggested as a novel tracer for detection of PCa relapses and metastases. The aim of this study was to evaluate the diagnostic value of PSMA PET/CT in the diagnosis of recurrent PCa with low prostate-specific antigen (PSA) levels. PATIENTS AND METHODS: We carried out a retrospective analysis of patients who underwent PSMA PET/CT from November 2013 to December 2014 in our department. Among these patients, 50 out of 178 who had increasing PSA levels (<5 ng/ml) and did not have known metastasis were included in this study. RESULTS:Patients had an average PSA of 1.41 ng/ml. A total of 29 patients (58%) showed at least one positive lesion. PET positivity rates of 31% (n=4), 54% (n=13), and 88% (n=14) were observed in patients with a PSA level of less than 0.2, 0.2-2, and 2-5 ng/ml, respectively. A positive correlation was observed between positivity rate and Gleason scores and blood PSA levels. Verification was performed in 46 patients, with biopsy (n=3) and follow-up, and conventional imaging studies at the time of the PET/CT or during follow-up with a mean period of 10.6±3.3 months and ranged from 3.8 to 16.4 months. According to patient-based analysis of 46 cases, 57% of patients had true positive, 24% of patients had true negative, 2% of patients had false positive, an 18% of patients had false-negative findings. A sensitivity of 76.47% (95% confidence interval: 58.83-89.25%) and a specificity of 91.67% (95% confidence interval: 61.52-99.79%) were found. CONCLUSION: PET/CT with Ga-PSMA is a valuable tool for assessing recurrence of PCa with a high sensitivity in patients who have PSA levels between 0.2 and 5 ng/ml. In addition, this study suggests that PSMA PET/CT can be used in patients with very low (<0.2 ng/ml) but increasing PSA levels, which, in many cases, may influence further clinical management.
Authors: Rohan Nandurkar; Pimmeke van Leeuwen; Phillip Stricker; Henry Woo; Rajdeep Kooner; Carlo Yuen; Gordon O'Neill; David Ende; Thomas Cusick; Bao Ho; Adam Hickey; Louise Emmett Journal: Br J Radiol Date: 2019-01-23 Impact factor: 3.039
Authors: Benedikt Kranzbühler; Hannes Nagel; Anton S Becker; Julian Müller; Martin Huellner; Paul Stolzmann; Urs Muehlematter; Matthias Guckenberger; Philipp A Kaufmann; Daniel Eberli; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2017-10-14 Impact factor: 9.236
Authors: Stefan A Koerber; Leon Will; Clemens Kratochwil; Matthias F Haefner; Henrik Rathke; Christophe Kremer; Jonas Merkle; Klaus Herfarth; Klaus Kopka; Peter L Choyke; Tim Holland-Letz; Uwe Haberkorn; Juergen Debus; Frederik L Giesel Journal: J Nucl Med Date: 2018-07-05 Impact factor: 10.057
Authors: Emre Demirci; Levent Kabasakal; Onur E Şahin; Elife Akgün; Mehmet Hamza Gültekin; Tünkut Doğanca; Mustafa B Tuna; Can Öbek; Mert Kiliç; Tarik Esen; Ali R Kural Journal: Nucl Med Commun Date: 2019-01 Impact factor: 1.690