Prostate‐specific membrane antigen‐based imaging in prostate cancer: Impact on clinical decision making process

Demirkol, Mehmet Onur; Acar, Ömer; Uçar, Burcu; Ramazanoglu, Sultan; Sağlıcan, Yeşim; Esen, Tarık

doi:10.1002/pros.22956

Cited by 56 publications

(31 citation statements)

References 26 publications

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“…By contrast, CT and MRI have low sensitivity for lymph node metastasis, with detection only of lesions >10 mm in diameter. Consequently, CT and MRI may fail to detect microscopic invasion of the lymph nodes [42,43]. In the present study, multiple lymph node involvements affecting the mediastinum, retroperitoneum and pelvis were detected in 8 patients using 68 Ga-PSMA-11 PET/CT, but were negative on CT and/or MRI.…”

Section: Discussionmentioning

confidence: 49%

68Ga-PSMA-11 PET/CT for prostate cancer staging and risk stratification in Chinese patients

et al. 2017

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We evaluated the clinical utility of 68Ga-PSMA-11 PET/CT for staging and risk stratification of treatment-naïve prostate cancer (PCa) and metastatic castrate-resistant prostate cancer (mCRPC). Twenty-two consecutive patients with treatment-naïve PCa and 18 with mCRPC were enrolled. 68Ga-PSMA-11 PET/CT and magnetic resonance imaging (MRI) were performed for the evaluation of primary prostatic lesions, and bone scans were used for evaluation bone metastasis. Among the 40 patients, 37 (92.5% [22 treatment-naïve PCa, 15 mCRPC]) showed PSMA-avid lesions on 68Ga-PSMA-11 images. Only 3 patients with stable mCRPC after chemotherapy were negative for PSMA. The sensitivity, specificity and accuracy of 68Ga-PSMA-11 imaging were 97.3%, 100.0% and 97.5%, respectively. The maximum standardized uptake (SUVmax) of prostatic lesions was 17.09 ± 11.08 and 13.33 ± 12.31 in treatment-naïve PCa and mCRPC, respectively. 68Ga-PSMA-11 revealed 105 metastatic lymph nodes in 15 patients; the SUVmax was 16.85 ± 9.70 and 7.54 ± 5.20 in treatment-naïve PCa and mCRPC, respectively. 68Ga-PSMA-11 PET/CT also newly detected visceral metastasis in 9 patients (22.5%) and bone metastasis in 29 patients (72.5%). 68Ga-PSMA-11 PET/CT exhibits potential for staging and risk stratification in naïve PCa, as well as improved sensitivity for detection of lymph node and remote metastasis.

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Section: Discussionmentioning

confidence: 49%

68Ga-PSMA-11 PET/CT for prostate cancer staging and risk stratification in Chinese patients

et al. 2017

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“…Note that for the cohort used by Afshar-Oromieh et al [14], not all patients (91.5%) had disease recurrence; however, given that they were in the overwhelming majority, we included this study in the analysis. Where a range was reported by a study as a PSA category, we took the midpoint of this range as the reference point for the category except for Sachpekidis et al [42], Demirkol et al [31], and Kabasakal et al [37], who reported individual patient-level data and manually calculated the reference point. Note that in the study by Kabasakal et al, only two out of 13 secondary staging patients had PSA <2 ng/ml, so the whole cohort was categorised in the 2 ng/ml PSA subpopulation.…”

Section: Data Extraction and Analysismentioning

confidence: 99%

“…One additional study was excluded as patients were enrolled following negative choline-based PET, and thus provided a skewed patient population [28]. This left 18 articles were suitable for assessment [14,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]; a summary of the search strategy is shown in Figure 1. On evaluation of predictive values for positive 68 Ga-PSMA PET, two studies included only patients with positive 68 Ga-PSMA PET findings and predictive data were not available for analysis [34,35].…”

Section: Evidence Synthesismentioning

confidence: 99%

Sensitivity, Specificity, and Predictors of Positive 68 Ga–Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer: A Systematic Review and Meta-analysis

et al. 2016

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“…Currently, there are no prospective data for the treatment of oligometastatic PC using PSMA PET for staging. However, a retrospective case collection of Demirkol et al describes significant therapy changes due to the high diagnostic value of 68 Ga-PSMA-PET [19]. …”

Section: Introductionmentioning

confidence: 99%

Oligometastases from prostate cancer: local treatment with stereotactic body radiotherapy (SBRT)

et al. 2017

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BackgroundThe impact of local tumor ablative therapy in oligometastasized prostate cancer (PC) is still under debate. To gain data for this approach, we evaluated oligometastasized PC patients receiving stereotactic body radiotherapy (SBRT) to bone metastases.MethodsIn this retrospective study, 15 oligometastasized PC patients with a total of 20 bone metastases were evaluated regarding biochemical progression-free survival (PSA-PFS), time to initiation of ADT, and local control rate (LCR). Three patients received concomitant androgen deprivation therapy (ADT).ResultsThe median follow-up after RT was 22.5 months (range 7.0–53.7 months). The median PSA-PFS was 6.9 months (range 1.1–28.4 months). All patients showing a decrease of PSA level after RT of at least factor 10 reveal a PSA-PFS of >12 months. Median PSA-PFS of this sub-group was 23.1 months (range 12.1–28.4 months). Local PFS (LPFS) after 2 years was 100%. One patient developed a local failure after 28.4 months. Median distant PFS (DPFS) was 7.36 months (range 1.74–54.34 months). The time to initiation of ADT in patients treated without ADT was 9.3 months (range 2.6–36.1 months). In all patients, the time to intensification of systemic therapy or the time to initiation of ADT increased from 9.3 to 12.3 months (range 2.6–36.1 months). Gleason-Score, ADT or the localization of metastasis had no impact on PFS or time to intensification of systemic therapy. No SBRT related acute or late toxicities were observed.ConclusionOur study shows that SBRT of bone metastases is a highly effective therapy with an excellent risk-benefit profile. However, PFS was limited due to a high distant failure rate implying the difficulty for patient selection for this oligometastatic concept. SBRT offers high local cancer control rates in bone oligometastases of PC and should be evaluated with the aim of curation or to delay modification of systemic treatment.

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Prostate‐specific membrane antigen‐based imaging in prostate cancer: Impact on clinical decision making process

Cited by 56 publications

References 26 publications

68Ga-PSMA-11 PET/CT for prostate cancer staging and risk stratification in Chinese patients

68Ga-PSMA-11 PET/CT for prostate cancer staging and risk stratification in Chinese patients

Sensitivity, Specificity, and Predictors of Positive 68 Ga–Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced Prostate Cancer: A Systematic Review and Meta-analysis

Oligometastases from prostate cancer: local treatment with stereotactic body radiotherapy (SBRT)

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