Gallium 68-PSMA PET/CT for lesion characterization in suspected cases of prostate carcinoma

Sasikumar, Arun; Joy, Ajith; Pillai, Ambikalmajan M.R.; Oommen, Karuna Elza; Somarajan, Sudin; Raman, Vikraman Kaithavelil; Thomas, Renu; Dhar, Dinesh

doi:10.1097/mnm.0000000000000906

Cited by 11 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After initial screening according to titles, eligible criteria, and removal of duplicates, a total of 25 articles were selected. Of these, 18 were finally included and downloaded in a full-text version [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. No further studies were added after examination of the references of these articles ( Figure 1 : PRISMA flowchart of the study).…”

Section: Resultsmentioning

confidence: 99%

The Role of [68Ga]PSMA PET/CT for Clinical Suspicion of Prostate Cancer in Patients with or without Previous Negative Biopsy: A Systematic Review

Caracciolo

Castello

Urso

et al. 2022

Cancers

View full text Add to dashboard Cite

The purpose of the study is to systematically evaluate the evidence regarding the role of [68Ga]PSMA PET/CT for clinical suspicions of prostate cancer in patients with or without previous negative biopsy. We performed a critical review of PubMed and Web of Science according to the PRISMA statement. Eighteen publications were selected for inclusion in this analysis. QUADAS-2 evaluation was adopted for quality analyses. [68Ga]PSMA-11 was the radiotracer of choice in 15 studies, while [68Ga]PSMA-617 was used in another 3. In 8 articles, there was a direct comparison with mpMRI. The total number of patients included was 1379, ranging from 15 to 291, with a median age of 64 years (range: 42–90). The median baseline PSA value was 12.9 ng/mL, ranging from 0.85 to 4156 ng/mL. Some studies evaluated the PSMA uptake comparing the SUVmax of suspicious lesions with the SUVmax of the normal biodistribution to find out optimal cut-off points. In addition, some studies suggested a significant association between PSA levels, PSA density, and [68Ga]PSMA PET/CT finding. [68Ga]PSMA PET/CT seems to be more accurate in identifying primary prostate cancer with PSA values between 4 and 20 ng/mL than mpMRI. Moreover, in some trials, the combination of PSMA PET/CT and MRI improved the NPV in the detection of clinically significant prostate cancer (csPCa) than MRI alone. Our findings are limited by the small numbers of studies and patient heterogeneity. [68Ga]PSMA PET/CT is a promising technique in patients with clinical suspicion of PCa and precedent negative biopsy or contraindications to MRI. Furthermore, its use combined with MRI improves sensitivity for csPCa detection and can avoid unnecessary biopsies.

show abstract

Section: Resultsmentioning

confidence: 99%

The Role of [68Ga]PSMA PET/CT for Clinical Suspicion of Prostate Cancer in Patients with or without Previous Negative Biopsy: A Systematic Review

Caracciolo

Castello

Urso

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…PSMA PET imaging may also be useful for selecting candidates for active surveillance. 22 PSMA PET imaging is also being studied as a theranostic tool to guide treatment planning for patients with both oligometastatic noncastrate disease and metastatic CRPC. For example, in a recent study by Tran and colleagues, the use of 18 F-DCFPyL PET imaging to guide treatment with stereotactic ablative radiotherapy to sites of spread in the oligometastatic setting significantly improved distant metastasisfree survival times compared to conventional imaging.…”

Section: Psma Pet Imaging In Prostate Cancer 111mentioning

confidence: 99%

“…In these settings, the improved sensitivity afforded by PSMA PET imaging for early detection of metastatic lesions may change treatment planning and could improve patient outcomes. PSMA PET imaging may also be useful for selecting candidates for active surveillance 22 …”

Section: Psma Pet Imaging In Prostate Cancermentioning

confidence: 99%

Meeting report from the Prostate Cancer Foundation PSMA theranostics state of the science meeting

et al. 2020

View full text Add to dashboard Cite

Introduction The Prostate Cancer Foundation (PCF) convened a PCF prostate‐specific membrane antigen (PSMA) Theranostics State of the Science Meeting on 18 November 2019, at Weill Cornell Medicine, New York, NY. Methods The meeting was attended by 22 basic, translational, and clinical researchers from around the globe, with expertise in PSMA biology, development and use of PSMA theranostics agents, and clinical trials. The goal of this meeting was to discuss the current state of knowledge, the most important biological and clinical questions, and critical next steps for the clinical development of PSMA positron emission tomography (PET) imaging agents and PSMA‐targeted radionuclide agents for patients with prostate cancer. Results Several major topic areas were discussed including the biology of PSMA, the role of PSMA‐targeted PET imaging in prostate cancer, the physics and performance of different PSMA‐targeted PET imaging agents, the current state of clinical development of PSMA‐targeted radionuclide therapy (RNT) agents, the role of dosimetry in PSMA RNT treatment planning, barriers and challenges in PSMA RNT clinical development, optimization of patient selection for PSMA RNT trials, and promising combination treatment approaches with PSMA RNT. Discussion This article summarizes the presentations from the meeting for the purpose of globally disseminating this knowledge to advance the use of PSMA‐targeted theranostic agents for imaging and treatment of patients with prostate cancer.

show abstract

“…Transrectal ultrasonography (TRUS)-guided biopsy is considered the gold standard for the diagnosis; however, the false-negative rate is significant. [ 1 ] Men with a clinical suspicion of prostatic carcinoma on the basis of an elevated prostate-specific antigen (PSA) level or an abnormal digital rectal examination (DRE) are typically evaluated with standard TRUS-guided biopsy of the prostate during which 12 cores are obtained. This approach is associated with the underdetection of high-grade (clinically significant) prostate cancers and the overdetection of low-grade (clinically insignificant) cancers.…”

Section: Introductionmentioning

confidence: 99%

“…[ 4 ] In 68 Ga-PSMA PET-CT scan done for initial staging in patients with biopsy-proven prostate carcinoma, 98.5% showed an abnormal tracer concentration in the prostate gland suggestive of the primary site. [ 1 ] Multiparametric magnetic resonance imaging (mpMRI) has improved lesion detection in prostate cancer care by identifying suspicious lesions suitable for MRI-TRUS fusion biopsy. However, there is a considerable false-positive rate for mpMRI.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Multiparametric Magnetic Resonance Imaging and Gallium-68 Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Detecting Carcinoma Prostate in Patients with Serum Prostate-Specific Antigen between 4 and 20 ng/ml

Soni

Verma

Shah

et al. 2021

Indian Journal of Nuclear Medicine

View full text Add to dashboard Cite

Introduction: We carried out this study to compare the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) and gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (Ga-68 PSMA PET/CT) to detect prostatic carcinoma in patients with serum prostate-specific antigen (PSA) between 4 and 20 ng/ml in prebiopsy setting. Materials and Methods: This prospective study evaluated men with serum PSA values between 4 and 20 ng/ml. All patients underwent mpMRI and Ga-68 PSMA PET/CT, followed by 12-core transrectal ultrasonography (TRUS)-guided biopsy to detect prostatic carcinoma. The diagnostic accuracy of mpMRI and PSMA PET/CT scan was compared with histopathological findings. Results: There were thirty patients included in the study with a median age of 73 years (age range: 69–79 years). The median total serum PSA was 8.0 ng/ml (5.0–19.9 ng/ml). Of these, 18 had an identifiable lesion on imaging and had histopathological findings suggestive of carcinoma prostate. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of mpMRI were 100%, 92.30%, 94.73%, and 100%, respectively, and that of PSMA PET scan were 94.44%, 100%, 100%, and 92.31%, respectively. The diagnostic accuracy of both was 96.67%. Conclusion: PSMA PET scan showed higher PPV and specificity while mpMRI showed higher sensitivity and NPV. The accuracy in predicting presence of carcinoma was the same for both. PSMA PET showed higher specificity and PPV and predicted the subsequent need of biopsy. In our study, the NPV of PET, though good, was lower than mpMRI. Prospective trials with larger sample size are needed. In combination, PET/MRI may achieve greater accuracy and may serve as investigation of choice.

show abstract

Gallium 68-PSMA PET/CT for lesion characterization in suspected cases of prostate carcinoma

Cited by 11 publications

References 24 publications

The Role of [68Ga]PSMA PET/CT for Clinical Suspicion of Prostate Cancer in Patients with or without Previous Negative Biopsy: A Systematic Review

The Role of [68Ga]PSMA PET/CT for Clinical Suspicion of Prostate Cancer in Patients with or without Previous Negative Biopsy: A Systematic Review

Meeting report from the Prostate Cancer Foundation PSMA theranostics state of the science meeting

Comparison of Multiparametric Magnetic Resonance Imaging and Gallium-68 Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Detecting Carcinoma Prostate in Patients with Serum Prostate-Specific Antigen between 4 and 20 ng/ml

Contact Info

Product

Resources

About