Is there a role for 11C-choline PET/CT in the early detection of metastatic disease in surgically treated prostate cancer patients with a mild PSA increase &lt;1.5 ng/ml?

Castellucci, Paolo; Fuccio, Chiara; Rubello, Domenico; Schiavina, Riccardo; Santi, Ivan; Nanni, Cristina; Allegri, Vincenzo; Montini, Gian Carlo; Ambrosini, Valentina; Boschi, Stefano; Martorana, Giuseppe; Marzola, Maria Cristina; Fanti, Stefano

doi:10.1007/s00259-010-1604-0

Cited by 156 publications

(112 citation statements)

References 25 publications

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“…in the group of hormone-resistant patients with PCa. Similar findings were obtained by Castellucci et al in 102 patients with PSA levels below 1.5 ng/ml [22]. Other studies that have shown a positive detection rate of the technique in both subgroups of patients, consistently showed higher percentage values in hormone-resistant patients than in hormone-sensitive patients [21,[23][24][25][26].…”

supporting

confidence: 78%

“…In this group of patients there are currently no available data derived from paired studies. However, useful information has been obtained from cross-sectional studies including a relatively large number of hormonesensitive and hormone-resistant patients in which the two groups were contrasted either semiquantitatively or by appropriate statistical analysis (logistic regression) [21,22].…”

mentioning

confidence: 99%

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Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Giovacchini

2011

Eur J Nucl Med Mol Imaging

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supporting

confidence: 78%

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confidence: 99%

Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Giovacchini

2011

Eur J Nucl Med Mol Imaging

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“…at PSA levels below 1-1.5 ng/mL (3,7,32,33). Thus, 68 Ga-PSMA ligand PET/CT improves lesion detectability in the group of patients at an early state, potentially allowing more tailored salvage therapies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

et al. 2015

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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 5 0.0190). No significant difference in detection efficacy was present regarding antiandrogen therapy (P 5 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.

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“…30-40% [13] [16]. Even though localized treatment of distant metastases currently is not an established therapy several reports have already been published, showing promising results regarding CH-PET/CT guided radiation therapy and salvage surgery [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

Soyka

Muster

Schmid

et al. 2012

Eur J Nucl Med Mol Imaging

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PURPOSE: To investigate the clinical value of (18)F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA). METHODS: The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14-64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires. RESULTS: Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted. CONCLUSION: CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment. Results: Mean follow-up was 42 months; mean Gleason Score was 6.9 at initial diagnosis. Initial treatment was: Radical prostatectomy (n=110), radiotherapy (n=39), combined prostatectomy and radiotherapy (n=7). Median PSA values before CH-PET/CT and at end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, dropped or were below measurable levels in 108 patients. PSA levels rose in 48 patients. In 75/156 patients (48%) treatment plan changed due to findings in CH-PET/CT. In 33 patients the therapeutic modality changed from a palliative to a curative intended treatment. In 15 patients the therapeutic modality was altered from a curative towards a palliative setting. 8 patients had a change from one curative modality to another and 2 patients from one palliative modality to another. 17 patients had adaptations within their therapeutic modality. Conclusion:CH-PET/CT has an important impact on therapeutic strategy in patients with recurrent prostate cancer and can help to determine an appropriate treatment.

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Is there a role for 11C-choline PET/CT in the early detection of metastatic disease in surgically treated prostate cancer patients with a mild PSA increase <1.5 ng/ml?

Cited by 156 publications

References 25 publications

Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

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Is there a role for 11C-choline PET/CT in the early detection of metastatic disease in surgically treated prostate cancer patients with a mild PSA increase <1.5 ng/ml?

Cited by 156 publications

References 25 publications

Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C]choline?

Evaluation of Hybrid 68Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

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Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy