PSMA PET/CT for Primary Staging of Prostate Cancer - An Updated Overview

Jochumsen, Mads Ryø; Bouchelouche, Kirsten

doi:10.1053/j.semnuclmed.2023.07.001

Cited by 14 publications

(9 citation statements)

References 47 publications

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“…We observed considerably lower sensitivity and specificity of [ 68 Ga]Ga-PSMA-11 PET-CT for predicting SVI (see Table 2) compared with previous work [32]. As the role of [ 68 Ga]Ga-PSMA-11 PET-CT in predicting EPE is not yet firmly established in the literature, we decided not to use [ 68 Ga]Ga-PSMA-11 PET-CT for this purpose in our study [33,34].…”

Section: Discussionmentioning

confidence: 66%

Comparison of Multiparametric MRI, [68Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer

Tayara,

Pełka,

Kunikowska

et al. 2023

Cancers

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Purpose of the Report: Although multiparametric magnetic resonance imaging (mpMRI) is commonly used for the primary staging of prostate cancer, it may miss non-enlarged metastatic lymph nodes. Positron emission tomography-computed tomography targeting the prostate-specific membrane antigen (PSMA PET-CT) is a promising method to detect non-enlarged metastatic lymph nodes, but more data are needed. Materials and Methods: In this single-center, prospective study, we enrolled patients with intermediate-to-high-risk prostate cancer scheduled for radical prostatectomy with pelvic node dissection. Before surgery, prostate imaging with mpMRI and PSMA PET-CT was used to assess lymph node involvement (LNI), extra-prostatic extension (EPE), and seminal vesicle involvement (SVI). Additionally, we used clinical nomograms to estimate the risk of these three outcomes. Results: Of the 74 patients included, 61 (82%) had high-risk prostate cancer, and the rest had intermediate-risk cancer. Histopathology revealed LNI in 20 (27%) patients, SVI in 26 (35%), and EPE in 52 (70%). PSMA PET-CT performed better than mpMRI at detecting LNI (area under the curve (AUC, 95% confidence interval): 0.779 (0.665–0.893) vs. 0.655 (0.529–0.780)), but mpMRI was better at detecting SVI (AUC: 0.775 (0.672–0.878) vs. 0.585 (0.473–0.698)). The MSKCC nomogram performed well at detecting both LNI (AUC: 0.799 (0.680–0.918)) and SVI (0.772 (0.659–0.885)). However, when the nomogram was used to derive binary diagnoses, decision curve analyses showed that the MSKCC nomogram provided less net benefit than mpMRI and PSMA PET-CT for detecting SVI and LNI, respectively. Conclusions: mpMRI and [68Ga]Ga-PSMA-11 PET-CT are complementary techniques to be used in conjunction for the primary T and N staging of prostate cancer.

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Section: Discussionmentioning

confidence: 66%

Comparison of Multiparametric MRI, [68Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer

Tayara,

Pełka,

Kunikowska

et al. 2023

Cancers

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“…In conclusion, PSMA PET/CT is the best imaging modality to point to positive sites of PCa. Staging PSMA PET/CT of high-risk PCa patients detects lymph node metastases for almost a third of the patients and bone metastases for a sixth of the patients, as reported in a recent review ( 25 ). The estimates fit with recent literature ( 6 - 14 ).…”

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confidence: 62%

To see clear is not enough; it is the action that counts

Hoffmann,

von Eyben

2024

Transl Androl Urol

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“…In parallel, several pitfalls have been described in the literature following the introduction of PSMA agents. In particular, unspecific bone uptake (UBU) on [ 18 F]F-PSMA-1007 PET has been reported in a considerable fraction of PCa patients, leading to a potential increase in false-positive metastases and, consequently, to inadequate treatments [25,26].…”

Section: Unspecific Bone Uptake: Mind the Gap!mentioning

confidence: 99%

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Urso,

Filippi,

Castello

et al. 2023

JCM

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Background: prostate-specific membrane antigen (PSMA) ligand PET has been recently incorporated into international guidelines for several different indications in prostate cancer (PCa) patients. However, there are still some open questions regarding the role of PSMA ligand PET in castration-resistant prostate cancer (CRPC). The aim of this work is to assess the clinical value of PSMA ligand PET/CT in patients with CRPC. Results: PSMA ligand PET has demonstrated higher detection rates in comparison to conventional imaging and allows for a significant reduction in the number of M0 CRPC patients. However, its real impact on patients’ prognosis is still an open question. Moreover, in CRPC patients, PSMA ligand PET presents some sensitivity and specificity limitations. Due to its heterogeneity, CRPC may present a mosaic of neoplastic clones, some of which could be PSMA−/FDG+, or vice versa. Likewise, unspecific bone uptake (UBU) and second primary neoplasms (SNPs) overexpressing PSMA in the neoangiogenic vessels represent potential specificity issues. Integrated multi-tracer imaging (PSMA ligand and [18F]FDG PET) together with a multidisciplinary discussion could allow for reaching the most accurate evaluation of each patient from a precision medicine point of view.

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PSMA PET/CT for Primary Staging of Prostate Cancer - An Updated Overview

Cited by 14 publications

References 47 publications

Comparison of Multiparametric MRI, [68Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer

Comparison of Multiparametric MRI, [68Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer

To see clear is not enough; it is the action that counts

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

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