Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy
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Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy. / Eiber, Matthias; Maurer, Tobias; Souvatzoglou, Michael; Beer, Ambros J; Ruffani, Alexander; Haller, Bernhard; Graner, Frank-Philipp; Kübler, Hubert; Haberkorn, Uwe; Eisenhut, Michael; Wester, Hans-Jürgen; Gschwend, Jürgen E; Schwaiger, Markus.
In: J NUCL MED, Vol. 56, No. 5, 05.2015, p. 668-74.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research
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TY - JOUR
T1 - Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy
AU - Eiber, Matthias
AU - Maurer, Tobias
AU - Souvatzoglou, Michael
AU - Beer, Ambros J
AU - Ruffani, Alexander
AU - Haller, Bernhard
AU - Graner, Frank-Philipp
AU - Kübler, Hubert
AU - Haberkorn, Uwe
AU - Eisenhut, Michael
AU - Wester, Hans-Jürgen
AU - Gschwend, Jürgen E
AU - Schwaiger, Markus
N1 - © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2015/5
Y1 - 2015/5
N2 - UNLABELLED: The expression of prostate-specific membrane antigen (PSMA) is increased in prostate cancer. Recently, (68)Ga-PSMA (Glu-NH-CO-NH-Lys-(Ahx)-[(68)Ga(HBED-CC)]) was developed as a PSMA ligand. The aim of this study was to investigate the detection rate of (68)Ga-PSMA PET/CT in patients with biochemical recurrence after radical prostatectomy.METHODS: Two hundred forty-eight of 393 patients were evaluable for a retrospective analysis. Median prostate-specific antigen (PSA) level was 1.99 ng/mL (range, 0.2-59.4 ng/mL). All patients underwent contrast-enhanced PET/CT after injection of 155 ± 27 MBq of (68)Ga-PSMA ligand. The detection rates were correlated with PSA level and PSA kinetics. The influence of antihormonal treatment, primary Gleason score, and contribution of PET and morphologic imaging to the final diagnosis were assessed.RESULTS: Two hundred twenty-two (89.5%) patients showed pathologic findings in (68)Ga-PSMA ligand PET/CT. The detection rates were 96.8%, 93.0%, 72.7%, and 57.9% for PSA levels of ≥2, 1 to <2, 0.5 to <1, and 0.2 to <0.5 ng/mL, respectively. Whereas detection rates increased with a higher PSA velocity (81.8%, 82.4%, 92.1%, and 100% in <1, 1 to <2, 2 to <5, and ≥5 ng/mL/y, respectively), no significant association could be found for PSA doubling time (82.7%, 96.2%, and 90.7% in >6, 4-6, and <4 mo, respectively). (68)Ga-PSMA ligand PET (as compared with CT) exclusively provided pathologic findings in 81 (32.7%) patients. In 61 (24.6%) patients, it exclusively identified additional involved regions. In higher Gleason score (≤7 vs. ≥8), detection efficacy was significantly increased (P = 0.0190). No significant difference in detection efficacy was present regarding antiandrogen therapy (P = 0.0783).CONCLUSION: Hybrid (68)Ga-PSMA ligand PET/CT shows substantially higher detection rates than reported for other imaging modalities. Most importantly, it reveals a high number of positive findings in the clinically important range of low PSA values (<0.5 ng/mL), which in many cases can substantially influence the further clinical management.
AB - UNLABELLED: The expression of prostate-specific membrane antigen (PSMA) is increased in prostate cancer. Recently, (68)Ga-PSMA (Glu-NH-CO-NH-Lys-(Ahx)-[(68)Ga(HBED-CC)]) was developed as a PSMA ligand. The aim of this study was to investigate the detection rate of (68)Ga-PSMA PET/CT in patients with biochemical recurrence after radical prostatectomy.METHODS: Two hundred forty-eight of 393 patients were evaluable for a retrospective analysis. Median prostate-specific antigen (PSA) level was 1.99 ng/mL (range, 0.2-59.4 ng/mL). All patients underwent contrast-enhanced PET/CT after injection of 155 ± 27 MBq of (68)Ga-PSMA ligand. The detection rates were correlated with PSA level and PSA kinetics. The influence of antihormonal treatment, primary Gleason score, and contribution of PET and morphologic imaging to the final diagnosis were assessed.RESULTS: Two hundred twenty-two (89.5%) patients showed pathologic findings in (68)Ga-PSMA ligand PET/CT. The detection rates were 96.8%, 93.0%, 72.7%, and 57.9% for PSA levels of ≥2, 1 to <2, 0.5 to <1, and 0.2 to <0.5 ng/mL, respectively. Whereas detection rates increased with a higher PSA velocity (81.8%, 82.4%, 92.1%, and 100% in <1, 1 to <2, 2 to <5, and ≥5 ng/mL/y, respectively), no significant association could be found for PSA doubling time (82.7%, 96.2%, and 90.7% in >6, 4-6, and <4 mo, respectively). (68)Ga-PSMA ligand PET (as compared with CT) exclusively provided pathologic findings in 81 (32.7%) patients. In 61 (24.6%) patients, it exclusively identified additional involved regions. In higher Gleason score (≤7 vs. ≥8), detection efficacy was significantly increased (P = 0.0190). No significant difference in detection efficacy was present regarding antiandrogen therapy (P = 0.0783).CONCLUSION: Hybrid (68)Ga-PSMA ligand PET/CT shows substantially higher detection rates than reported for other imaging modalities. Most importantly, it reveals a high number of positive findings in the clinically important range of low PSA values (<0.5 ng/mL), which in many cases can substantially influence the further clinical management.
KW - Aged
KW - Aged, 80 and over
KW - Edetic Acid
KW - Humans
KW - Kinetics
KW - Ligands
KW - Male
KW - Middle Aged
KW - Multimodal Imaging
KW - Oligopeptides
KW - Positron-Emission Tomography
KW - Prostate-Specific Antigen
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Recurrence
KW - Retrospective Studies
KW - Tomography, X-Ray Computed
KW - Evaluation Studies
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.2967/jnumed.115.154153
DO - 10.2967/jnumed.115.154153
M3 - SCORING: Journal article
C2 - 25791990
VL - 56
SP - 668
EP - 674
JO - J NUCL MED
JF - J NUCL MED
SN - 0161-5505
IS - 5
ER -
