Multicenter ProstaScint imaging findings in 2154 patients with prostate cancer

Sodee, D. Bruce; Malguria, Nagina; Faulhaber, Peter; Resnick, Martin I.; Albert, Jeffrey M.; Bakale, G.

doi:10.1016/s0090-4295(00)00824-4

Cited by 92 publications

(34 citation statements)

References 27 publications

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“…15 In a large, multicenter study of 877 patients with a mean serum PSA level of 8.9 ng/mL after undergoing surgical resection of the prostate, a 10-fold increase in serum PSA level was associated with a 1.23-fold higher risk of a positive capromab pendetide uptake in the prostatic fossa. 23 Additional studies have suggested that a low serum PSA level after primary treatment of prostate carcinoma may be associated with a negative capromab pendetide scan. 10,24 In an analysis of 100 consecutive patients who experienced recurrent disease after undergoing primary treatment for prostate carcinoma, lower serum PSA levels were more likely to be associated with a negative 111 In-capromab pendetide scan (n ϭ 17 patients; mean serum PSA, 1.56 ng/mL) rather than a positive 111 In-capromab pendetide scan (n ϭ 103 patients; serum PSA, 65.2 ng/mL).…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy

Raj

Partin

Polascik

2002

Cancer

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BACKGROUNDDespite the ability of radical prostatectomy to eradicate prostate carcinoma, biochemical evidence of recurrent prostate carcinoma may be seen in approximately 40% of patients 15 years after they undergo surgery. Localization of recurrent disease after radical prostatectomy is difficult and may greatly influence subsequent clinical management. The authors examined the utility of indium 111 (111In)‐capromab pendetide immunoscintigraphy to detect recurrent prostate carcinoma radiographically in men with early biochemical evidence of failure (serum prostate specific antigen [PSA] ≤ 4.0 ng/mL) and assessed the minimum serum PSA level necessary for imaging recurrent disease.METHODSBetween May 1987 and August 1995, 255 hormone‐naïve men with a mean (± standard deviation) age of 65 years ± 7 years who underwent radical prostatectomy for clinically localized prostate carcinoma were followed without adjuvant therapy until early PSA recurrence in this multicenter study. Preoperatively, all patients had negative bone scans and pathologically negative lymph nodes, and they did not undergo hormonal ablation, chemotherapy, or radiation therapy preoperatively or postoperatively until the 111In‐capromab pendetide scan was performed. All men in this study had postoperative serum PSA levels ≤ 4.0 ng/mL at the time of radionuclide imaging. All men underwent imaging with the capromab pendetide scan to localize recurrent disease, and charts were reviewed to document clinical evidence of recurrence.RESULTSPathologic findings included mean Gleason scores of 6.7 ± 1.2; pathologic tumors classified as pT2a (18%), pT2b (26%), pT3a (38%), pT3b (16%), and pT4a (2%); a pathologic lymph node status of pN0 (100%); positive surgical margins (44%); and perineural invasion (42%). Capromab pendetide uptake was seen in 72% of 255 men throughout a range of patients' postoperative serum PSA levels (0.1–4.0 ng/mL), with 31% of men having local uptake (prostatic fossa) only. Of 151 men who underwent additional imaging studies, 16 of 139 men (12%) and 15 of 92 men (16%) showed evidence of recurrent disease by bone scintigraphy and computed tomography scans, respectively. Gleason score, pathologic stage, perineural invasion, and margin status were not correlated significantly with the 111In‐capromab pendetide scan.CONCLUSIONSCapromab pendetide imaging can localize early PSA recurrence and may guide appropriate treatment after patients undergo radical prostatectomy. No minimum serum PSA value was needed to potentially detect radiographic disease after surgery. Further confirmatory studies and long‐term follow‐up of this cohort documenting response to salvage therapy are needed to validate these imaging findings. Cancer 2002;94:987–96. © 2002 American Cancer Society.DOI 10.1002/cncr.10337

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Section: Discussionmentioning

confidence: 99%

Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy

Raj

Partin

Polascik

2002

Cancer

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“…Within the limitations of this study, including its retrospective nature, varied treatment decision-making philosophies among different radiotherapy providers (for instance, strong pelvic uptake was viewed as a marker for distant disease by some providers and as loco-regional disease by others) and the occasional false positives (due to uptake in the supraclavicular region in one case and to uptake in the bowel in another), RIS does appear to be one additional advantageous tool in the salvage radiotherapy decision-making process. However, it is important to consider that the extra-pelvic sensitivity (75%) and negative predictive value (67%) preclude the use of RIS as the sole criterion for decision-making; 23,25 the RIS results must be used in the context of other available clinical information when making the decision to administer post-RRP radiotherapy.…”

Section: Patient Selectionmentioning

confidence: 99%

“…MRI allows visualization of gross disease to a greater extent than CT but still has a low diagnostic yield if the PSA is low. 16 The role of RIS is better examined in this setting with multi-institutional studies 23,25 demonstrating an overall accuracy of approximately 80%.…”

Section: Radiotherapy Target Designmentioning

confidence: 99%

“…[20][21][22][23][24][25][26][27][28][29][30][31] The most common type of RIS employs capromab pendetide (Prostascint, Cytogen Corporation, Princeton, NJ), a site-specific murine monoclonal antibody labeled with indium-111 that is reactive with prostate specific membrane antigen, a glycoprotein expressed by prostate tissue. It is strongly reactive with both primary and metastatic prostate carcinoma in addition to normal prostate tissue.…”

mentioning

confidence: 99%

“…Several studies have been done documenting the efficacy of RIS in evaluating post-RRP disease, including multi-institutional analyses. 23,25 The approximate values for diagnostic parameters of RIS in the post-surgery setting are: sensitivity 75% (extraprostatic), 92% (prostate fossa); specificity 86%; positive predictive value 81%; negative predictive value 67%. 21,23,25,26 These parameters for RIS, particularly the sensitivity figures, are higher than the corresponding values for CT, ultrasound or digital rectal examination.…”

mentioning

confidence: 99%

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The Role of Indium-111 Radioimmunoscintigraphy in Post-Radical Retropubic Prostatectomy Management of Prostate Cancer Patients

Jani¹,

Liauw²,

Blend³

2007

Clinical Medicine & Research

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Indium-111 radioimmunoscintigraphy (RIS) has an increasing role in the treatment of prostate cancer and is most commonly performed at this disease site using labeled monoclonal antibody against prostate-specific membrane antigen. There are many limitations of RIS, including low spatial resolution, low diagnostic yield and limited availability. Despite these limitations, the efficacy of RIS has been demonstrated in many clinical studies, including multi-institutional investigations. The highest sensitivity and specificity of RIS appears to be in the post-radical retropubic prostatectomy (post-RRP) setting. RIS has recently been explored for its role in clinical radiotherapy decision-making, and was found to have a significant impact in selecting patients for radiotherapy and for the general radiotherapy treatment volume definition. RIS has also recently been explored for its role in radiotherapy planning and was found to impact clinical target volume design. However, manual editing of the RIS volume is still necessary when projected into the radiotherapy-planning scan, as there is often overlap in the RIS-defined uptake regions with normal structures (rectum, bladder and symphysis bone marrow). The impact of RIS on biochemical control has been explored, with studies in this area yielding conflicting results. It appears that the maximum impact of RIS is possible when areas of labeled antibody uptake regions are co-registered with the radiotherapy-planning computed tomography scan.The larger RIS-guided target volumes do not appear to be prohibitive in increasing radiotherapy-related toxicity. Future directions of the use of RIS for post-RRP prostate cancer are discussed.

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Radical Prostatectomy After Radical Radiotherapy

Kaisary¹

2006

Challenges in Prostate Cancer

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Multicenter ProstaScint imaging findings in 2154 patients with prostate cancer

Cited by 92 publications

References 27 publications

Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy

Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy

The Role of Indium-111 Radioimmunoscintigraphy in Post-Radical Retropubic Prostatectomy Management of Prostate Cancer Patients

Radical Prostatectomy After Radical Radiotherapy

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