Rising PSA after a Radical Treatment

Carroll, Peter R.

doi:10.1159/000049879

Cited by 33 publications

(16 citation statements)

References 64 publications

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“…Lymph node dissection boundries extended proximally from the common iliac bifurcation, laterally to the medial aspect of the external iliac artery, distally to the lymph node of Cloquet, and included the hypogastric and obturator fossae. 11 Median follow-up in this series for the 180 N0 patients was 12.7 years (range, 1.5 years to 19.1 years), and for the 94 Nϩ patients median follow-up was 13.6 years (range, 0.9 years to 19.7 years); for the entire cohort of 274 patients, median follow-up was 12.9 years (Table 2). One hundred eighty six of 283 patients (66%) were N0 by routine histology, 94 of 283 patients (33%) were node positive (Nϩ), and lymph node status was not available for three patients.…”

Section: Patient Populationmentioning

confidence: 76%

Detection of Occult Lymph Node Metastases in Locally Advanced Node-Negative Prostate Cancer

Pagliarulo

Hawes

Brands

et al. 2006

JCO

111

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Section: Patient Populationmentioning

confidence: 76%

Detection of Occult Lymph Node Metastases in Locally Advanced Node-Negative Prostate Cancer

Pagliarulo

Hawes

Brands

et al. 2006

JCO

111

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“…While men with localized prostate cancer are treated with the curative intent, approximately 40% of patients will experience a detectable rise in the serum PSA level (biochemical failure) within 10 years from the primary treatment (3). Locally recurrent cancer is eventually detected in about 25–35%, metastatic disease only in about 20–25% and both local recurrence and metastatic disease in 45–55% of men with biochemical failure (4). While most men with metastatic disease respond to androgen deprivation therapy, many will develop castrate-resistant state within 1–3 years with the hallmark of tumor growth despite castrate levels of serum androgens (5, 6).…”

Section: Introductionmentioning

confidence: 99%

Imaging evaluation of prostate cancer with 18F-fluorodeoxyglucose PET/CT: utility and limitations

Jadvar

2013

Eur J Nucl Med Mol Imaging

140

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Prostate cancer poses a major public health problem in the developed countries. The remarkable biological and clinical heterogeneity of prostate cancer provides unique opportunities as well as challenges for the diagnostic imaging evaluation of this prevalent disease. The disease is characterized by a natural history that ranges from localized slowly-growing hormone-dependent tumor progressing to metastatic hormone-refractory disease. Positron emission tomography (PET) is an ideal imaging tool for noninvasive interrogation of the underlying tumor biology. Fluorine-18 fluorodeoxyglucose (FDG) is the most common PET radiotracer used for oncologic applications which is based upon elevated glucose metabolism in malignant tissue in comparison to normal tissue. FDG uptake in the prostate cancer depends on tumor differentiation with low accumulation in well-differentiated tumors and high uptake in aggressive poorly-differentiated tumors. Cumulative current evidence suggests that FDG PET may be useful in detection of disease in a small fraction of patients with biochemical recurrence, in the imaging evaluation of extent and treatment response in metastatic disease and in prediction of patient outcome.

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“…14 Locally recurrent cancer is eventually detected in approximately 25% to 35%, metastatic disease only in approximately 20% to 25%, and both local recurrence and metastatic disease in 45% to 55% of men with biochemical failure. 1,15 …”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of 18F-NaF and 18F-FDG PET/CT in Detection of Occult Metastatic Disease in Biochemical Recurrence of Prostate Cancer

Jadvar¹,

Desai²,

Ji³

et al. 2012

Clinical Nuclear Medicine

127

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Purpose This study aimed to perform a prospective evaluation of 18F-NaF and 18F-FDG PET/CT in the detection of occult metastatic disease in men with prostate cancer and biochemical relapse. Methods Thirty-seven men with prostate-specific antigen (PSA) relapse (median, 3.2 ng/mL; range, 0.5–40.2 ng/mL) after definitive therapy for localized prostate cancer [26 radical prostatectomy (RP), 11 external beam radiation therapy] and negative conventional imaging underwent 18F-FDG and 18F-NaF PET/CT on 2 separate days within the same week. Studies were interpreted by 2 experienced radiologists in consensus for abnormal uptake suspicious for metastatic disease. The reference standard was a combination of imaging and clinical follow-up. Rank of PSA values for positive and negative PET/CT was compared using analysis of variance adjusting for primary therapy. Association between PSA and scan positivity in patients with RP was evaluated using Wilcoxon rank sum test. Results Result of the 18F-FDG PET/CT scan was positive for nodal disease in 2 patients. True-positive detection rate for occult osseous metastases by 18F-NaF PET/CT was 16.2%. Median PSA levels for positive versus negative PET/CT scans were 4.4 and 2.9 ng/mL, respectively, with the difference marginally significant in prostatectomized men (P = 0.072). Percentages of patients with either 18F-NaF– or 18F-FDG–positive PET/CT in RP and external beam radiation therapy were 10% (n = 10) and undefined (n = 0) for a PSA of 2 ng/mL or less, 29% (n = 7) and 50% (n = 2) for PSA greater than 2 ng/mL but 4 ng/mL or less,60% (n = 5) and 40%(n = 5) for PSA greater than 4 ng/mL but 10 ng/mL or less, and 25% (n = 4) and 25% (n = 4) for PSA greater than 10 ng/mL, respectively. Conclusions In biochemical relapse of prostate cancer, 18F-NaF PET/CT is useful in the detection of occult osseous metastases, whereas the yield of 18F-FDG PET/CT is relatively limited. 18F-NaF PET/CT positivity tends to associate with increasing PSA level in prostatectomized men and may occur in lower PSA ranges than conventionally recognized.

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Rising PSA after a Radical Treatment

Cited by 33 publications

References 64 publications

Detection of Occult Lymph Node Metastases in Locally Advanced Node-Negative Prostate Cancer

Detection of Occult Lymph Node Metastases in Locally Advanced Node-Negative Prostate Cancer

Imaging evaluation of prostate cancer with 18F-fluorodeoxyglucose PET/CT: utility and limitations

Prospective Evaluation of 18F-NaF and 18F-FDG PET/CT in Detection of Occult Metastatic Disease in Biochemical Recurrence of Prostate Cancer

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