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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-02-2015 | Original Article

The diagnostic value of PET/CT imaging with the ⁶⁸Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer

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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2015

Abstract

Purpose

Since the introduction of positron emission tomography (PET) imaging with ⁶⁸Ga-PSMA-HBED-CC (=⁶⁸Ga-DKFZ-PSMA-11), this method has been regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). However, published data exist for small patient cohorts only. The aim of this evaluation was to analyse the diagnostic value of ⁶⁸Ga-PSMA-ligand PET/CT in a large cohort and the influence of several possibly interacting variables.

Methods

We performed a retrospective analysis in 319 patients who underwent ⁶⁸Ga-PSMA-ligand PET/CT from 2011 to 2014. Potential influences of several factors such as prostate-specific antigen (PSA) level and doubling time (DT), Gleason score (GSC), androgen deprivation therapy (ADT), age and amount of injected tracer were evaluated. Histological verification was performed in 42 patients after the ⁶⁸Ga-PSMA-ligand PET/CT. Tracer uptake was measured in 901 representative tumour lesions.

Results

In 82.8 % of the patients at least one lesion indicative of PCa was detected. Tumor-detection was positively associated with PSA level and ADT. GSC and PSA-DT were not associated with tumor-detection. The average maximum standardized uptake value (SUV_max) of tumour lesions was 13.3 ± 14.6 (0.7–122.5). Amongst lesions investigated by histology, 30 were false-negative in 4 different patients, and all other lesions (n = 416) were true-positive or true-negative. A lesion-based analysis of sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) revealed values of 76.6 %, 100 %, 91.4 % and 100 %. A patient-based analysis revealed a sensitivity of 88.1 %. Of 116 patients available for follow-up, 50 received local therapy after ⁶⁸Ga-PSMA-ligand PET/CT.

Conclusion

⁶⁸Ga-PSMA-ligand PET/CT can detect recurrent PCa in a high number of patients. In addition, the radiotracer is highly specific for PCa. Tumour detection is positively associated with PSA and ADT. ⁶⁸Ga-PSMA-ligand PET/CT can help delay systemic therapy of PCa.

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Title: The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer
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
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-014-2949-6

At a glance: The ONWARDS insulin icodec trials

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The diagnostic value of PET/CT imaging with the ⁶⁸Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

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Abstract

Purpose

Methods

Results

Conclusion

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