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European Journal of Nuclear Medicine and Molecular Imaging

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01-03-2020 | Prostate Cancer | Original Article

Impact of ⁶⁸Ga-PSMA-11 PET staging on clinical decision-making in patients with intermediate or high-risk prostate cancer

Authors: Daniela A. Ferraro, Helena I. Garcia Schüler, Urs J. Muehlematter, Daniel Eberli, Julian Müller, Alexander Müller, Roger Gablinger, Helmut Kranzbühler, Aurelius Omlin, Philipp A. Kaufmann, Thomas Hermanns, Irene A. Burger

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2020

Abstract

Background

Accurate staging is of major importance to determine the optimal treatment modality for patients with prostate cancer. Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) is a promising technique that outperformed conventional imaging in the detection of nodal and distant metastases in previous studies. However, it is still unclear whether the superior sensitivity and specificity also translate into improved patient management. The aim of this study was to assess the performance of ⁶⁸Ga-PSMA-11 PET for staging of intermediate and high-risk prostate cancer and its potential impact on disease management.

Methods

In this retrospective analysis, 116 patients who underwent ⁶⁸Ga-PSMA-11 PET/CT or MRI scans for staging of their intermediate or high-risk prostate cancer between April 2016 and May 2018 were included. The potential impact of ⁶⁸Ga-PSMA-11 PET staging on patient management was assessed within a simulated multidisciplinary tumour board where hypothetical treatment decisions based on clinical information and conventional imaging alone was determined. This treatment decision was compared with the treatment recommendation based on clinical information and ⁶⁸Ga-PSMA-11 PET imaging.

Results

The primary tumour was positive on ⁶⁸Ga-PSMA-11 PET in 113 patients (97%). Nodal metastases were detected in 28 patients (24%) and bone metastases in 14 patients (12%). Compared with clinical staging and conventional imaging, ⁶⁸Ga-PSMA-11 PET resulted in new information in 42 of 116 patients (36%). In 32 of 116 patients (27%), this information would most likely have changed the management into a different therapy modality (15 patients, 13%) or adjusted treatment details (e.g. modification of radiotherapy field or lymph node dissection template; 17 patients, 14%).

Conclusion

Information from ⁶⁸Ga-PSMA-11 PET staging has the potential to change the management in more than a fourth of the patients who underwent PET staging for their intermediate to high-risk prostate cancer. Whether these more personalized ⁶⁸Ga-PSMA-11 PET-based treatment decisions will improve patient outcome needs further investigation.

Available only for authorised users

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Title: Impact of 68Ga-PSMA-11 PET staging on clinical decision-making in patients with intermediate or high-risk prostate cancer
Authors: Daniela A. Ferraro
Helena I. Garcia Schüler
Urs J. Muehlematter
Daniel Eberli
Julian Müller
Alexander Müller
Roger Gablinger
Helmut Kranzbühler
Aurelius Omlin
Philipp A. Kaufmann
Thomas Hermanns
Irene A. Burger
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Metastasis
Computed Tomography
Prostate Cancer
Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04568-1

At a glance: The STEP trials

Springer Medicine

Impact of ⁶⁸Ga-PSMA-11 PET staging on clinical decision-making in patients with intermediate or high-risk prostate cancer

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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