Radioimmunoguided imaging of prostate cancer foci with histopathological correlation

Ellis, Rodney J.; Kim, Edward Y.; Conant, Ridgely; Sodee, D. Bruce; Spirnak, J. Patrick; Dinchman, Kurt H.; Beddar, Sam; Wessels, Barry W.; Resnick, Martin I.; Kinsella, Timothy J.

doi:10.1016/s0360-3016(00)01582-0

Cited by 50 publications

(18 citation statements)

References 20 publications

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“…Recently, there has been considerable enthusiasm for 111 Indium Capromab Pendetide (ProstaScint TM scan) in the detection of microscopic prostate cancer. 1,2 The ProstaScint TM scan has generally been used to stage and detect local recurrences following treatment failures from either radiation therapy or radical prostatectomy. Elgamal et al, 3 reported a sensitivity of 89% for the detection of lymph node metastases in patients who had failed radical prostatectomy or radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of preoperative ProstaScint™ scans in the prediction of nodal disease

Ponsky

Cherullo

Starkey

et al. 2002

Prostate Cancer Prostatic Dis

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Diagnostic methods are limited for detecting microscopic soft tissue metastases in patients with prostate cancer. Previous studies using 111 Indium Capromab Pendetide (ProstaScint TM scan) analyzed patients with extensive localized tumor (prostate specific antigen (PSA) > 20 ng/ml) not optimal for surgical therapy. We evaluated the role of the ProstaScint TM scan in a preoperative population to provide histological documentation and to assess its utility in a surgical population. A total of 22 preoperative patients, underwent a ProstaScint TM scan. The mean preoperative PSA was 16.0 ng/ml (range 3.9 -33 ng/ml). The mean Gleason score at biopsy was 6.9 (range 6 -9). Each patient underwent a radical retropubic prostatectomy and bilateral pelvic lymph node dissection, which included resection of both obturator and common iliac lymph nodes. Histologic analysis of the resected lymph nodes provided the standard of comparison with the ProstaScint TM scan. The results of the scan and pathology for all 22 patients were compared with the bilateral obturator and iliac nodes, creating 88 data points. Nine areas (10%) were positive on the scan. One of these (11%) was a true positive while the other eight (89%) were false positives. Seventy-nine areas (90%) were negative on scan results. Of these, five areas (6%) were false negatives and 74 areas (94%) were true negatives. The scan yielded a sensitivity of 17%, specificity of 90%, negative predictive value (NPV) of 94% and a positive predictive value (PPV) of 11%. The high false positive rate and low PPV of ProstaScint scans overestimates metastatic lymph nodes disease, and is not useful when used preoperatively.

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Section: Discussionmentioning

confidence: 99%

Evaluation of preoperative ProstaScint™ scans in the prediction of nodal disease

Ponsky

Cherullo

Starkey

et al. 2002

Prostate Cancer Prostatic Dis

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“…Taken together, these studies potentially suggest a role for 111 In-capromab pendetide scanning in clinical decision making for patients with biochemical evidence of failure after definitive therapy. However, a prospective randomized trial is indicated to evaluate the histologic 45 and clinical efficacy of the 111 In-capromab pendetide scan to identify appropriate candidates for salvage radiation therapy.…”

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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“…The ProstaScint-CT fusion scan then was used to identify targets within the prostate for dose escalation. The authors also have previously reported the use of this technique to identify intraprostatic foci of disease with 79% sensitivity, 80% specificity, and an accuracy of 80% when correlated with histopathologic results in a small patient cohort [17]. The seed distribution then was tailored to increase treatment doses in areas that were consistent with high tumor burden, sparing those who appeared to have low tumor burden.…”

Section: Treatment Planningmentioning

confidence: 99%

Brachytherapy: Update and results

Ellis

Kim

2003

Curr prostate rep

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Radioimmunoguided imaging of prostate cancer foci with histopathological correlation

Cited by 50 publications

References 20 publications

Evaluation of preoperative ProstaScint™ scans in the prediction of nodal disease

Evaluation of preoperative ProstaScint™ scans in the prediction of nodal disease

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

Brachytherapy: Update and results

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