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European Journal of Nuclear Medicine and Molecular Imaging

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01-01-2018 | Original Article

Clinical performance of ⁶⁸Ga-PSMA-11 PET/MRI for the detection of recurrent prostate cancer following radical prostatectomy

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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2018

Abstract

Purpose

Sensitive visualization of recurrent prostate cancer foci is a challenge in patients with early biochemical recurrence (EBR). The recently established ⁶⁸Ga-PSMA-11 PET/CT has significantly improved the detection rate with published values of up to 55% for patients with a serum PSA concentration between 0.2–0.5 ng/mL. The increased soft tissue contrast in the pelvis using simultaneous ⁶⁸Ga-PSMA-11 PET/MRI might further improve the detection rate in patients with EBR and low PSA values over PET/CT.

Methods

We retrospectively analyzed a cohort of 56 consecutive patients who underwent a ⁶⁸Ga-PSMA-11 PET/MRI for biochemical recurrence in our institution between April and December 2016 with three readers. Median PSA level was 0.99 ng/mL (interquartile range: 3.1 ng/mL). Detection of PSMA-positive lesions within the prostate fossa, local and distant lymph nodes, bones, or visceral organs was recorded. Agreement among observers was evaluated with Fleiss’s kappa (k).

Results

Overall, in 44 of 56 patients (78.6%) PSMA-positive lesions were detected. In four of nine patients (44.4%) with a PSA < 0.2 ng/mL, suspicious lesions were detected (two pelvic and one paraaortic lymph nodes, and two bone metastases). In eight of 11 patients (72.7%) with a PSA between 0.2 and < 0.5 ng/mL, suspicious lesions were detected (two local recurrences, six lymph nodes, and one bone metastasis). Five out of 20 patients with a PSA < 0.5 ng/mL had extrapelvic disease. In 12 of 15 patients (80.0%) with a PSA between 0.5 and < 2.0 ng/mL, suspicious lesions were detected (four local recurrences, nine lymph nodes, and four bone metastases). In 20 of 21 patients (95.2%) with a PSA >2.0 ng/mL, suspicious lesions were detected. The overall interreader agreement for cancer detection was excellent (κ = 0.796, CI 0.645–0.947).

Conclusions

Our data show that ⁶⁸Ga-PSMA-11 PET/MRI has a high detection rate for recurrent prostate cancer even at very low PSA levels <0.5 ng/mL. Furthermore, even at those low levels extrapelvic disease can be localized in 25% of the cases and local recurrence alone is seen only in 10%.

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Title: Clinical performance of 68Ga-PSMA-11 PET/MRI for the detection of recurrent prostate cancer following radical prostatectomy
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
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3850-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical performance of ⁶⁸Ga-PSMA-11 PET/MRI for the detection of recurrent prostate cancer following radical prostatectomy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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