Lorenzo Bianchi1,2, Riccardo Schiavina1,2, Marco Borghesi1,2, Francesco Ceci3,4, Andrea Angiolini1, Francesco Chessa1, Matteo Droghetti1, Alessandro Bertaccini1,2, Fabio Manferrari1,2, Emanuela Marcelli2,3,4,5, Giovanni Cochetti6, Angelo Porreca7, Paolo Castellucci3, Stefano Fanti3, Eugenio Brunocilla1,2. 1. Department of Urology, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy. 2. Department of Specialist, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy. 3. Metropolitan Nuclear Medicine, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy. 4. Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, California, USA. 5. Laboratory of Bioengineering, Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. 6. Department of Surgical and Biomedical Sciences, Institute of Urological, Andrological Surgery and Minimally Invasive Techniques, Perugia, Italy. 7. Department of Urology, Abano Terme Hospital, Padua, Italy.
Abstract
OBJECTIVE: To evaluate the clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography on the planned management of prostate cancer patients with biochemical recurrence after surgery. METHODS: We enrolled 276 prostate cancer patients referred to 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography due to biochemical recurrence after surgery (two consecutive prostate-specific antigen assays ≥0.2 ng/mL). First, the detection rate of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed according to different prostate-specific antigen levels. Second, the independent predictors of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography positive results were assessed. Finally, the intended treatment before revision of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed by a multidisciplinary team based on the European Association of Urology guidelines, patient clinical condition and clinical parameters. Then, re-assessment of the treatment plan was prospectively recorded by the same board after revision of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography. The effective clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was rated as major (change in therapeutic approach), minor (same treatment, but modified therapeutic strategy) or none. RESULTS: The overall detection rate of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was 47.5%. Prostate-specific antigen at 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (odds ratio 3.52) and prostate-specific antigen doubling time <3 months (odds ratio 3.98) were independent predictors of positive 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography results (all P ≤ 0.03). 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography led to a major treatment change in 177 cases (64.1%), with a minor clinical impact of 2.5%. The overall clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was 42.4%, 27.7%, 21.2% and 8.7% in men with prostate-specific antigen at 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography of 0.2-0.4, 0.5-1, 1.1-2 and >2 ng/mL, respectively. CONCLUSIONS: 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography allows clinicians to radically change the intended treatment approach before imaging evaluation, in roughly two out three individuals.
OBJECTIVE: To evaluate the clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography on the planned management of prostate cancerpatients with biochemical recurrence after surgery. METHODS: We enrolled 276 prostate cancerpatients referred to 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography due to biochemical recurrence after surgery (two consecutive prostate-specific antigen assays ≥0.2 ng/mL). First, the detection rate of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed according to different prostate-specific antigen levels. Second, the independent predictors of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography positive results were assessed. Finally, the intended treatment before revision of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed by a multidisciplinary team based on the European Association of Urology guidelines, patient clinical condition and clinical parameters. Then, re-assessment of the treatment plan was prospectively recorded by the same board after revision of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography. The effective clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was rated as major (change in therapeutic approach), minor (same treatment, but modified therapeutic strategy) or none. RESULTS: The overall detection rate of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was 47.5%. Prostate-specific antigen at 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (odds ratio 3.52) and prostate-specific antigen doubling time <3 months (odds ratio 3.98) were independent predictors of positive 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography results (all P ≤ 0.03). 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography led to a major treatment change in 177 cases (64.1%), with a minor clinical impact of 2.5%. The overall clinical impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography was 42.4%, 27.7%, 21.2% and 8.7% in men with prostate-specific antigen at 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography of 0.2-0.4, 0.5-1, 1.1-2 and >2 ng/mL, respectively. CONCLUSIONS: 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography allows clinicians to radically change the intended treatment approach before imaging evaluation, in roughly two out three individuals.
Authors: Niloefar Ahmadi Bidakhvidi; Annouschka Laenen; Sander Jentjens; Christophe M Deroose; Koen Van Laere; Liesbeth De Wever; Cindy Mai; Charlien Berghen; Gert De Meerleer; Karin Haustermans; Steven Joniau; Wouter Everaerts; Karolien Goffin Journal: EJNMMI Res Date: 2021-04-30 Impact factor: 3.138
Authors: Thijs H Huits; Henk B Luiting; Henk G van der Poel; Rohan Nandurkar; Maarten Donswijk; Eva Schaake; Wouter Vogel; Monique J Roobol; Esther Wit; Phillip Stricker; Louise Emmett; Pim J van Leeuwen Journal: BJU Int Date: 2020-04-23 Impact factor: 5.588
Authors: Patrick Bowden; Andrew W See; Kevin So; Nathan Lawrentschuk; Daniel Moon; Declan G Murphy; Ranjit Rao; Alan Crosthwaite; Dennis King; Hodo Haxhimolla; Jeremy Grummet; Paul Ruljancich; Dennis Gyomber; Adam Landau; Nicholas Campbell; Mark Frydenberg; Lloyd M L Smyth; Skye Nolan; Stella M Gwini; Dean P McKenzie Journal: World J Urol Date: 2021-06-02 Impact factor: 4.226