Purpose: Several studies have demonstrated an advantage of 68Ga-PSMA-PET/CT as staging modality for detection of prostate cancer (PCa) metastases. Data concerning metastatic manifestation and impact on PCa development of mesorectal lymph nodes (MLN) is limited. Our investigation describes MLN metastases as index lesion in 68Ga-PSMA PET/CT imaging for recurrent PCa. Methods: Twelve PCa patients with biochemical recurrence (BCR) after primary therapy who prospectively underwent a baseline 68Ga-PSMA-PET/CT initially showed MLN metastases. Eight of these patients received a follow-up 68Ga-PSMA-PET/CT to evaluate treatment response and further evolution. Prostate-specific antigen (PSA)-levels, changes in PSMA-uptake of MLN metastases and further 68Ga-PSMA PET/CT findings were recorded. Results: Median PSA at the first 68Ga-PSMA-PET/CT was 5.39 ng/ml. In all patients therapeutic management changed after the first 68Ga-PSMA-PET/CT. Androgen deprivation therapy (ADT) was initiated in seven of eight patients, one patient restarted initial ADT. Three patients additionally received salvage radiation therapy (sRT) including the prostatic lodge and docetaxel chemotherapy was started in one case. At follow-up, a decrease of PSA-level was detected in all patients (median 2.05 ng/ml) after median 10 months. In six of eight patients we observed a decrease or complete regress of PSMA-uptake in MLN in the follow-up 68Ga-PSMA-PET/CT. Conclusion: MLN metastases detected by 68Ga-PSMA-PET/CT seem to be a relevant localization of tumor manifestation and may serve as index lesion in the treatment of recurrent PCa. Besides the known oncological benefits of ADT and sRT, in case of sole MLN metastases individualized therapy like salvage lymphadenectomy or RT with a defined radiation field could be options for these patients.
Purpose: Several studies have demonstrated an advantage of 68Ga-PSMA-PET/CT as staging modality for detection of prostate cancer (PCa) metastases. Data concerning metastatic manifestation and impact on PCa development of mesorectal lymph nodes (MLN) is limited. Our investigation describes MLN metastases as index lesion in 68Ga-PSMA PET/CT imaging for recurrent PCa. Methods: Twelve PCa patients with biochemical recurrence (BCR) after primary therapy who prospectively underwent a baseline 68Ga-PSMA-PET/CT initially showed MLN metastases. Eight of these patients received a follow-up 68Ga-PSMA-PET/CT to evaluate treatment response and further evolution. Prostate-specific antigen (PSA)-levels, changes in PSMA-uptake of MLN metastases and further 68Ga-PSMA PET/CT findings were recorded. Results: Median PSA at the first 68Ga-PSMA-PET/CT was 5.39 ng/ml. In all patients therapeutic management changed after the first 68Ga-PSMA-PET/CT. Androgen deprivation therapy (ADT) was initiated in seven of eight patients, one patient restarted initial ADT. Three patients additionally received salvage radiation therapy (sRT) including the prostatic lodge and docetaxel chemotherapy was started in one case. At follow-up, a decrease of PSA-level was detected in all patients (median 2.05 ng/ml) after median 10 months. In six of eight patients we observed a decrease or complete regress of PSMA-uptake in MLN in the follow-up 68Ga-PSMA-PET/CT. Conclusion:MLN metastases detected by 68Ga-PSMA-PET/CT seem to be a relevant localization of tumor manifestation and may serve as index lesion in the treatment of recurrent PCa. Besides the known oncological benefits of ADT and sRT, in case of sole MLN metastases individualized therapy like salvage lymphadenectomy or RT with a defined radiation field could be options for these patients.
Authors: Philip Cornford; Joaquim Bellmunt; Michel Bolla; Erik Briers; Maria De Santis; Tobias Gross; Ann M Henry; Steven Joniau; Thomas B Lam; Malcolm D Mason; Henk G van der Poel; Theo H van der Kwast; Olivier Rouvière; Thomas Wiegel; Nicolas Mottet Journal: Eur Urol Date: 2016-08-31 Impact factor: 20.096
Authors: Joshua J Morigi; Phillip D Stricker; Pim J van Leeuwen; Reuben Tang; Bao Ho; Quoc Nguyen; George Hruby; Gerald Fogarty; Raj Jagavkar; Andrew Kneebone; Adam Hickey; Stefano Fanti; Lisa Tarlinton; Louise Emmett Journal: J Nucl Med Date: 2015-06-25 Impact factor: 10.057
Authors: Nicolas Mottet; Joaquim Bellmunt; Michel Bolla; Erik Briers; Marcus G Cumberbatch; Maria De Santis; Nicola Fossati; Tobias Gross; Ann M Henry; Steven Joniau; Thomas B Lam; Malcolm D Mason; Vsevolod B Matveev; Paul C Moldovan; Roderick C N van den Bergh; Thomas Van den Broeck; Henk G van der Poel; Theo H van der Kwast; Olivier Rouvière; Ivo G Schoots; Thomas Wiegel; Philip Cornford Journal: Eur Urol Date: 2016-08-25 Impact factor: 20.096
Authors: David Pfister; Daniel Porres; Axel Heidenreich; Isabel Heidegger; Ruth Knuechel; Florian Steib; Florian F Behrendt; Frederik A Verburg Journal: Eur J Nucl Med Mol Imaging Date: 2016-03-19 Impact factor: 9.236
Authors: Isabel Rauscher; Tobias Maurer; Ambros J Beer; Frank-Philipp Graner; Bernhard Haller; Gregor Weirich; Alan Doherty; Jürgen E Gschwend; Markus Schwaiger; Matthias Eiber Journal: J Nucl Med Date: 2016-06-03 Impact factor: 10.057
Authors: Colleen A F Lawton; Jeff Michalski; Issam El-Naqa; Mark K Buyyounouski; W Robert Lee; Cynthia Menard; Elizabeth O'Meara; Seth A Rosenthal; Mark Ritter; Michael Seider Journal: Int J Radiat Oncol Biol Phys Date: 2008-10-22 Impact factor: 7.038
Authors: Ali Afshar-Oromieh; Eleni Avtzi; Frederik L Giesel; Tim Holland-Letz; Heinz G Linhart; Matthias Eder; Michael Eisenhut; Silvan Boxler; Boris A Hadaschik; Clemens Kratochwil; Wilko Weichert; Klaus Kopka; Jürgen Debus; Uwe Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2014-11-20 Impact factor: 9.236
Authors: Henk B Luiting; Pim J van Leeuwen; Martijn B Busstra; Tessa Brabander; Henk G van der Poel; Maarten L Donswijk; André N Vis; Louise Emmett; Phillip D Stricker; Monique J Roobol Journal: BJU Int Date: 2019-11-29 Impact factor: 5.588