PURPOSE: We compared the use of 11C-choline and 68Ga-prostate specific membrane antigen in men undergoing salvage lymph node dissection for nodal recurrent prostate cancer. MATERIALS AND METHODS: The study included 641 patients who experienced prostate specific antigen rise and nodal recurrence after radical prostatectomy and underwent salvage lymph node dissection. Lymph node recurrence was documented by positron emission tomography/computerized tomography using 11C-choline (407, 63%) or 68Ga-PSMA ligand (234, 37%). The outcome was underestimation of tumor burden (difference between number of positive nodes on final pathology and number of positive spots at positron emission tomography/computerized tomography). Multivariable analysis tested the association between positron emission tomography/computerized tomography tracer (11C-choline vs 68Ga-PSMA) and tumor burden underestimation. RESULTS: Overall the extent of tumor burden underestimation was significantly higher in the 11C-choline group compared to the 68Ga-PSMA group (p <0.0001), which was confirmed on multivariable analysis (p=0.028). Repeating these analyses according to prostate specific antigen, tumor burden underestimation was lower with 68Ga-PSMA only when prostate specific antigen was 1.5 ng/ml or less. Conversely, the underestimation of the 2 tracers became similar when prostate specific antigen was greater than 1.5 ng/ml. Furthermore, we evaluated the risk of underestimation by number of positive spots on positron emission tomography/computerized tomography. The higher the number of positive spots the higher the underestimation of tumor burden regardless of the tracer used (p=0.2). CONCLUSIONS: Positron emission tomography/computerized tomography significantly underestimates the burden of prostate cancer recurrence, regardless of the tracer used. 68Ga-PSMA was associated with a lower rate of underestimation in patients with a prostate specific antigen below 1.5 ng/ml and a limited nodal tumor load. In all other men there was no benefit from 68Ga-PSMA over 11C-choline in assessing the extent of nodal recurrence.
PURPOSE: We compared the use of 11C-choline and 68Ga-prostate specific membrane antigen in men undergoing salvage lymph node dissection for nodal recurrent prostate cancer. MATERIALS AND METHODS: The study included 641 patients who experienced prostate specific antigen rise and nodal recurrence after radical prostatectomy and underwent salvage lymph node dissection. Lymph node recurrence was documented by positron emission tomography/computerized tomography using 11C-choline (407, 63%) or 68Ga-PSMA ligand (234, 37%). The outcome was underestimation of tumor burden (difference between number of positive nodes on final pathology and number of positive spots at positron emission tomography/computerized tomography). Multivariable analysis tested the association between positron emission tomography/computerized tomography tracer (11C-choline vs 68Ga-PSMA) and tumor burden underestimation. RESULTS: Overall the extent of tumor burden underestimation was significantly higher in the 11C-choline group compared to the 68Ga-PSMA group (p <0.0001), which was confirmed on multivariable analysis (p=0.028). Repeating these analyses according to prostate specific antigen, tumor burden underestimation was lower with 68Ga-PSMA only when prostate specific antigen was 1.5 ng/ml or less. Conversely, the underestimation of the 2 tracers became similar when prostate specific antigen was greater than 1.5 ng/ml. Furthermore, we evaluated the risk of underestimation by number of positive spots on positron emission tomography/computerized tomography. The higher the number of positive spots the higher the underestimation of tumor burden regardless of the tracer used (p=0.2). CONCLUSIONS: Positron emission tomography/computerized tomography significantly underestimates the burden of prostate cancer recurrence, regardless of the tracer used. 68Ga-PSMA was associated with a lower rate of underestimation in patients with a prostate specific antigen below 1.5 ng/ml and a limited nodal tumor load. In all other men there was no benefit from 68Ga-PSMA over 11C-choline in assessing the extent of nodal recurrence.
Authors: Philip Sutera; Ryan M Phillips; Matthew Deek; Gokhan Ozyigit; Cem Onal; Phuoc T Tran Journal: J Nucl Med Date: 2022-01-20 Impact factor: 10.057
Authors: Shafak Aluwini; Daniela E Oprea-Lager; Hilda de Barros; Niven Mehra; Herman Stoevelaar; Derya Yakar; Henk van der Poel Journal: BJUI Compass Date: 2021-02-03
Authors: Fahad Quhal; Pawel Rajwa; Keiichiro Mori; Ekaterina Laukhtina; Nico C Grossmann; Victor M Schuettfort; Frederik König; Abdulmajeed Aydh; Reza S Motlagh; Satoshi Katayama; Hadi Mostafai; Benjamin Pradere; Giancarlo Marra; Paolo Gontero; Romain Mathieu; Pierre I Karakiewicz; Alberto Briganti; Shahrokh F Shariat; Axel Heidenreich Journal: Prostate Date: 2021-05-31 Impact factor: 4.104
Authors: Simon Kirste; Stephanie G C Kroeze; Christoph Henkenberens; Nina-Sophie Schmidt-Hegemann; Marco M E Vogel; Jessica Becker; Constantinos Zamboglou; Irene Burger; Thorsten Derlin; Peter Bartenstein; Juri Ruf; Christian la Fougère; Matthias Eiber; Hans Christiansen; Stephanie E Combs; Arndt-Christian Müller; Claus Belka; Matthias Guckenberger; Anca-Ligia Grosu Journal: Front Oncol Date: 2021-05-10 Impact factor: 6.244
Authors: Juho Jasu; Teemu Tolonen; Emmanuel S Antonarakis; Himisha Beltran; Susan Halabi; Mario A Eisenberger; Michael A Carducci; Yohann Loriot; Kim Van der Eecken; Martijn Lolkema; Charles J Ryan; Sinja Taavitsainen; Silke Gillessen; Gunilla Högnäs; Timo Talvitie; Robert J Taylor; Antti Koskenalho; Piet Ost; Teemu J Murtola; Irina Rinta-Kiikka; Teuvo Tammela; Anssi Auvinen; Paula Kujala; Thomas J Smith; Pirkko-Liisa Kellokumpu-Lehtinen; William B Isaacs; Matti Nykter; Juha Kesseli; G Steven Bova Journal: Eur Urol Open Sci Date: 2021-07-02