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European Journal of Nuclear Medicine and Molecular Imaging

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01-03-2016 | Original Article

Extent of disease in recurrent prostate cancer determined by [⁶⁸Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score

Authors: Frederik A. Verburg, David Pfister, Axel Heidenreich, Andreas Vogg, Natascha I. Drude, Stefan Vöö, Felix M. Mottaghy, Florian F. Behrendt

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2016

Abstract

Purpose

To examine the relationship between the extent of disease determined by [⁶⁸Ga]PSMA-HBED-CC-PET/CT and the important clinical measures prostate-specific antigen (PSA), PSA doubling time (PSAdt) and Gleason score.

Methods

We retrospectively studied the first 155 patients with recurrent prostate cancer (PCA) referred to our university hospital for [⁶⁸Ga]PSMA-HBED-CC PET/CT.

Results

PET/CT was positive in 44 %, 79 % and 89 % of patients with PSA levels of ≤1, 1 – 2 and ≥2 ng/ml, respectively. Patients with high PSA levels showed higher rates of local prostate tumours (p < 0.001), and extrapelvic lymph node (p = 0.037) and bone metastases (p = 0.013). A shorter PSAdt was significantly associated with pelvic lymph node (p = 0.026), extrapelvic lymph node (p = 0.001), bone (p < 0.001) and visceral (p = 0.041) metastases. A high Gleason score was associated with more frequent pelvic lymph node metastases (p = 0.039). In multivariate analysis, both PSA and PSAdt were independent determinants of scan positivity and of extrapelvic lymph node metastases. PSAdt was the only independent marker of bone metastases (p = 0.001). Of 20 patients with a PSAdt <6 months and a PSA ≥2 ng/ml, 19 (95 %) had a positive scan and 12 (60 %) had M1a disease. Of 14 patients with PSA <1 ng/ml and PSAdt >6 months, only 5 (36 %) had a positive scan and 1 (7 %) had M1a disease.

Conclusion

[⁶⁸Ga]PSMA-HBED-CC PET/CT will identify PCA lesions even in patients with very low PSA levels. Higher PSA levels and shorter PSAdt are independently associated with scan positivity and extrapelvic metastases, and can be used for patient selection for [⁶⁸Ga]PSMA-HBED-CC PET/CT.

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Title: Extent of disease in recurrent prostate cancer determined by [68Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score
Authors: Frederik A. Verburg
David Pfister
Axel Heidenreich
Andreas Vogg
Natascha I. Drude
Stefan Vöö
Felix M. Mottaghy
Florian F. Behrendt
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3240-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extent of disease in recurrent prostate cancer determined by [⁶⁸Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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