Ken Herrmann1, Wolfgang Peter Fendler1,2, Andrea Farolfi3,1, Andrei Gafita4, Jeremie Calais2, Matthias Eiber4, Ali Afshar-Oromieh5,6, Fabian Spohn5, Francesco Barbato1, Manuel Weber1, Harun Ilhan7, Veronica Cervati3, Axel Wetter8, Boris Hadaschik9, Alberto Briganti10, Jochen Walz11, Davide Pianori12, Stefano Fanti3, Uwe Haberkorn5,13. 1. Department of Nuclear Medicine, University Hospital Essen, Essen. 2. Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California-Los Angeles, Los Angeles, California. 3. Service of Nuclear Medicine, S.Orsola Hospital, Bologna. 4. Departments of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich. 5. Department of Nuclear Medicine, Heidelberg University Hospital, German Cancer Research Center, Heidelberg, Germany. 6. Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 7. University Hospital Munich, Ludwig-Maximilians-Universität, Munich. 8. Department of Radiology, University Hospital Essen, Essen. 9. Department of Urology, University Hospital Essen, Essen. 10. Department of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. 11. Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France. 12. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna. 13. Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany.
Abstract
PURPOSE: Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68%) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35%) had disease confined to the pelvis while 57 of 173 (33%) had distant lesions. The most frequently affected nodal regions were the obturator in 42% and the presacral/mesorectal region in 40%. In 15 of the 33 patients (45%) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24%) had new lesions (positron emission tomography recurrence) and 10 (30%) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91%. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.
PURPOSE:Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68%) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35%) had disease confined to the pelvis while 57 of 173 (33%) had distant lesions. The most frequently affected nodal regions were the obturator in 42% and the presacral/mesorectal region in 40%. In 15 of the 33 patients (45%) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24%) had new lesions (positron emission tomography recurrence) and 10 (30%) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91%. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.
Authors: Andrea Farolfi; Harun Ilhan; Andrei Gafita; Jeremie Calais; Francesco Barbato; Manuel Weber; Ali Afshar-Oromieh; Fabian Spohn; Axel Wetter; Christoph Rischpler; Boris Hadaschik; Davide Pianori; Stefano Fanti; Uwe Haberkorn; Matthias Eiber; Ken Herrmann; Wolfgang Peter Fendler Journal: J Nucl Med Date: 2019-12-05 Impact factor: 10.057
Authors: Francesco Ceci; Daniela E Oprea-Lager; Louise Emmett; Judit A Adam; Jamshed Bomanji; Johannes Czernin; Matthias Eiber; Uwe Haberkorn; Michael S Hofman; Thomas A Hope; Rakesh Kumar; Steven P Rowe; Sarah M Schwarzenboeck; Stefano Fanti; Ken Herrmann Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-19 Impact factor: 9.236
Authors: Justin Ferdinandus; Wolfgang P Fendler; Andrea Farolfi; Samuel Washington; Osama Mohamad; Miguel H Pampaloni; Peter J H Scott; Melissa Rodnick; Benjamin L Viglianti; Matthias Eiber; Ken Herrmann; Johannes Czernin; Wesley R Armstrong; Jeremie Calais; Thomas A Hope; Morand Piert Journal: J Nucl Med Date: 2021-10-07 Impact factor: 11.082
Authors: Wietske I Luining; Matthijs C F Cysouw; Dennie Meijer; N Harry Hendrikse; Ronald Boellaard; André N Vis; Daniela E Oprea-Lager Journal: Cancers (Basel) Date: 2022-02-24 Impact factor: 6.639