Diagnostic performance of 68Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms

Zhang, Jingliang; Shao, Shuai; Wu, Ping; Liu, Daliang; Yang, Bo; Han, Donghui; Liu, Yu; Lin, Xiaoyu; Song, Wei; Cao, Milin; Zhang, Jing; Kang, Fei; Qin, Weijun; Wang, Jing

doi:10.1007/s00259-018-4255-1

Cited by 47 publications

(42 citation statements)

References 45 publications

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“…The reason was that the calculation in the previous study was performed in benign prostatic hyperplasia (BPH) 25 , which was characterized by slightly higher uptake values than the normal prostate corresponding to our study. Like the previous study reported 15 , our results showed that the clinical utility and benefit of 68 Ga-PSMA-617 PET/ CT was superior to that of mpMRI by decision-curve analysis, and SUVratio might be the preferred diagnostic parameter in the detection of PCa with PSA levels of 4-20 ng/ml.…”

Section: Discussionsupporting

confidence: 78%

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

Han

et al. 2020

Sci Rep

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The study was aimed at assessing the diagnostic performance of 68 Ga-PSMA-617 PET/CT in the detection of prostate cancer (PCa) in patients with a prostate-specific antigen (PSA) level of 4-20 ng/ ml and to compare its efficacy with that of multiparametric MRI (mpMRI). We analyzed the data of 67 consecutive patients with PSA levels of 4-20 ng/ml who almost simultaneously underwent 68 Ga-PSMA-617 PET/CT and mpMRI. 68 Ga-PSMA-617 PET/CT and mpMRI diagnostic performances were compared via receiver operating characteristic (ROC) curve analysis. Of the 67 suspected PCa cases, 33 had pathologically confirmed PCa. 68 Ga-PSMA-617 PET/CT showed a patient-based sensitivity, specificity, and positive and negative predictive values (PPVs and NPVs) of 87.88%, 88.24%, 87.88%, and 88.24%, respectively. The corresponding values for mpMRI were 84.85%, 52.94%, 63.64%, and 78.26%. The area under the curve values for 68 Ga-PSMA-617 PET/CT and mpMRI were 0.881 and 0.689, respectively. 68 Ga-PSMA-617 PET/CT showed a better diagnostic performance than mpMRI in the detection of PCa in patients with PSA levels of 4-20 ng/ml.

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Section: Discussionsupporting

confidence: 78%

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

Han

et al. 2020

Sci Rep

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“…As shown by the results of this study, when miPSMA score 0-1 is used as negative 68 Ga-PSMA-PET/CT imaging criteria, it provides higher negative predictive value for the diagnosis and suggests a higher probability to obtain a negative result following a repeat biopsy. This concords with a recent report by Zhang et al (22); among patients requiring prostate biopsy according to ERSPC-RC3 criteria (European Randomized Study of Screening for Prostate Cancer risk calculator-level 3). 19% of these patients could potentially avoid unnecessary biopsy if negative 68 Ga-PSMA PET/CT imaging results were followed.…”

Section: Discussioncontrasting

confidence: 44%

⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

Liu

Zhang

et al. 2020

J Nucl Med

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parameters to predict the outcome of repeat prostate biopsy. Results: The median age of patients was 65 years (range 53-81), and the median PSA level was 18.0 ng/ml (range 5.48-49.77 ng/ml). Prostate cancer was detected in 15/31 patients (48.4%) and 12/31 patients (38.7%) had clinically significant disease. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 68 Ga-PSMA PET/CT in the diagnosis of clinically significant prostate cancer were 100.0%, 68.4%, 66.7%, 100.0% and 80.6%, respectively. The detection rate of prostate cancer increased with the increase of miPSMA-ES score. The detection rate of clinically significant prostate cancer in miPSMA-ES 0-1, 2 and 3 groups were 0%, 54.5% and 85.7% respectively. Semi-quantitative analysis of 68 Ga-PSMA PET/CT images showed that predictive models based on maximum standardized uptake value (SUVmax), tumor-to-background normal prostate SUV (SUVT/BGp) and tumor-to-background normal liver SUV (SUVratio) could effectively predict clinically significant prostate cancer; area under the curves were 0.930, 0.877, and 0.956, respectively. Conclusion: This study preliminarily confirmed that 68 Ga-PSMA PET/CT imaging combined with PET-ultrasound fusion image-guided prostate biopsy can effectively detect clinically significant prostate cancer. Prebiopsy 68 Ga-PSMA PET/CT has predictive value for clinically significant cancer in the studied patient population.

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“…Given its high efficacy for detection of lymphatic metastases, PSMA-PET/CT may also become the standard of care in lymph node staging and preoperative planning prior to lymph node dissection. Other potential applications of PSMA-PET/CT currently under investigation include identification of the suspected primary site of PCa, primary staging of intermediate-to-high risk PCa, and targeted biopsy [ 42 , 43 , 44 , 45 ].…”

Section: Uses and Impact Of Psma-targeted Imagingmentioning

confidence: 99%

PSMA Theranostics: Review of the Current Status of PSMA-Targeted Imaging and Radioligand Therapy

Jones

Griffiths

Barata

et al. 2020

Cancers

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Prostate-specific membrane antigen (PSMA) has been the subject of extensive investigation in the past two decades as a promising molecular target for prostate cancer (PCa). Its appealing molecular features have enabled the development of a novel diagnostic and therapeutic—thus “theranostic”—approach to PCa. There is now substantial evidence of the high sensitivity of PSMA-targeted imaging for PCa lesions and growing evidence of the therapeutic efficacy of PSMA radioligand therapy for metastatic castration-resistant prostate cancer. This article presents a broad overview of the current status of PSMA theranostics, including current evidence, potential clinical impact, and active areas of research.

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Diagnostic performance of 68Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms

Cited by 47 publications

References 45 publications

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

PSMA Theranostics: Review of the Current Status of PSMA-Targeted Imaging and Radioligand Therapy

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Diagnostic performance of 68Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms

Cited by 47 publications

References 45 publications

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

Comparison of 68Ga-PSMA-617 PET/CT with mpMRI for the detection of PCa in patients with a PSA level of 4–20 ng/ml before the initial biopsy

68Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

PSMA Theranostics: Review of the Current Status of PSMA-Targeted Imaging and Radioligand Therapy

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⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results