The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Krause, Bernd J.; Souvatzoglou, Michael; Tuncel, Murat; Herrmann, Ken; Buck, Andreas K.; Praus, C.; Schuster, Tibor; Geinitz, Hans; Treiber, Uwe; Schwaiger, Markus

doi:10.1007/s00259-007-0581-4

Cited by 345 publications

(220 citation statements)

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“…Our data, based on a large and highly selected patient cohort, are in line with preliminary reports by Afshar-Oromieh (17,23). Compared with reports in the literature stating detection rates between 34% and 88% for 11 C-choline, 43%-79% for 18 F-choline, and 59%-80% for 11 C-acetate (7,(24)(25)(26)(27)(28)(29)(30)(31), 68 Ga-PSMA ligand PET/ CT offers a substantially higher detection efficacy. As known from other PET tracers, the detection rate of 68 Ga-PSMA ligand PET/ CT also increases in parallel with rising PSA value (4).…”

Section: Discussionsupporting

confidence: 77%

mentioning

confidence: 99%

“…For PET imaging, mainly 11 C-and 11 F-labeled choline derivates have been used in the past (7)(8)(9). However, especially in patients with PSA values below 3 ng/mL, the detection rate is only 40%-60% (3,4,7). Recently, a new molecular probe targeting, for example, the gastrinreleasing peptide receptor or the prostate-specific membrane antigen (PSMA), has been developed (10)(11)(12).…”

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Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

et al. 2015

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The expression of prostate-specific membrane antigen (PSMA) is increased in prostate cancer. Recently, 68 Ga-PSMA (Glu-NH-CO-NH-Lys-(Ahx)-[ 68 Ga(HBED-CC)]) was developed as a PSMA ligand. The aim of this study was to investigate the detection rate of 68 Ga-PSMA PET/CT in patients with biochemical recurrence after radical prostatectomy. Methods: Two hundred forty-eight of 393 patients were evaluable for a retrospective analysis. Median prostate-specific antigen (PSA) level was 1.99 ng/mL (range, 0.2-59.4 ng/mL). All patients underwent contrast-enhanced PET/CT after injection of 155 ± 27 MBq of 68 Ga-PSMA ligand. The detection rates were correlated with PSA level and PSA kinetics. The influence of antihormonal treatment, primary Gleason score, and contribution of PET and morphologic imaging to the final diagnosis were assessed. Results: Two hundred twenty-two (89.5%) patients showed pathologic findings in 68 Ga-PSMA ligand PET/CT. The detection rates were 96.8%, 93.0%, 72.7%, and 57.9% for PSA levels of $2, 1 to ,2, 0.5 to ,1, and 0.2 to ,0.5 ng/mL, respectively. Whereas detection rates increased with a higher PSA velocity (81.8%, 82.4%, 92.1%, and 100% in ,1, 1 to ,2, 2 to ,5, and $5 ng/mL/y, respectively), no significant association could be found for PSA doubling time (82.7%, 96.2%, and 90.7% in .6, 4-6, and ,4 mo, respectively). 68 Ga-PSMA ligand PET (as compared with CT) exclusively provided pathologic findings in 81 (32.7%) patients. In 61 (24.6%) patients, it exclusively identified additional involved regions. In higher Gleason score (#7 vs. $8), detection efficacy was significantly increased (P 5 0.0190). No significant difference in detection efficacy was present regarding antiandrogen therapy (P 5 0.0783). Conclusion: Hybrid 68 Ga-PSMA ligand PET/CT shows substantially higher detection rates than reported for other imaging modalities. Most importantly, it reveals a high number of positive findings in the clinically important range of low PSA values (,0.5 ng/mL), which in many cases can substantially influence the further clinical management.

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Section: Discussionsupporting

confidence: 77%

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confidence: 99%

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Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

et al. 2015

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“…Even though the exact role of the examination is still being discussed it seems that CH-PET/CT starts playing a role in the management of patients with a biochemical relapse [10] [11]. Several studies have demonstrated that CH-PET/CT either labeled with C-11 [12] [13] or with F-18 [14] [15] can detect tumor recurrence at PSA levels of above 2ng/ml giving the clinicians the opportunity of a curative intended salvage procedure at an early time-point of the recurrence [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…30-40% [13] [16]. Even though localized treatment of distant metastases currently is not an established therapy several reports have already been published, showing promising results regarding CH-PET/CT guided radiation therapy and salvage surgery [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

Soyka

Muster

Schmid

et al. 2012

Eur J Nucl Med Mol Imaging

100

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PURPOSE: To investigate the clinical value of (18)F-fluorocholine PET/CT (CH-PET/CT) in treatment decisions in patients with recurrent prostate cancer (rPCA). METHODS: The study was a retrospective evaluation of 156 patients with rPCA and CH-PET/CT for restaging. Questionnaires for each examination were sent to the referring physicians 14-64 months after examination. Questions included information regarding initial extent of disease, curative first-line treatment, and the treatment plan before and after CH-PET/CT. Additionally, PSA values at diagnosis, after initial treatment, before CH-PET/CT and at the end of follow-up were also obtained from the questionnaires. RESULTS: Mean follow-up was 42 months. The mean Gleason score was 6.9 at initial diagnosis. Initial treatment was: radical prostatectomy in 110 patients, radiotherapy in 39, and combined prostatectomy and radiotherapy in 7. Median PSA values before CH-PET/CT and at the end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, decreased or were below measurable levels in 108 patients. PSA levels increased in 48 patients. In 75 of the 156 patients (48%) the treatment plan was changed due to the CH-PET/CT findings. In 33 patients the therapeutic plan was changed from palliative treatment to treatment with curative intent. In 15 patients treatment was changed from curative to palliative. In 8 patients treatment was changed from curative to another strategy and in 2 patients from one palliative strategy to another. In 17 patients the treatment plan was adapted. CONCLUSION: CH-PET/CT has an important impact on the therapeutic strategy in patients with rPCA and can help to determine an appropriate treatment. Results: Mean follow-up was 42 months; mean Gleason Score was 6.9 at initial diagnosis. Initial treatment was: Radical prostatectomy (n=110), radiotherapy (n=39), combined prostatectomy and radiotherapy (n=7). Median PSA values before CH-PET/CT and at end of follow-up were 3.40 ng/ml and 0.91 ng/ml. PSA levels remained stable, dropped or were below measurable levels in 108 patients. PSA levels rose in 48 patients. In 75/156 patients (48%) treatment plan changed due to findings in CH-PET/CT. In 33 patients the therapeutic modality changed from a palliative to a curative intended treatment. In 15 patients the therapeutic modality was altered from a curative towards a palliative setting. 8 patients had a change from one curative modality to another and 2 patients from one palliative modality to another. 17 patients had adaptations within their therapeutic modality. Conclusion:CH-PET/CT has an important impact on therapeutic strategy in patients with recurrent prostate cancer and can help to determine an appropriate treatment.

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Imaging in Diagnosis and Staging of Urological Cancers: Ultrasound, CT, and PET

Rioja

Mamoulakis

Gravas

et al. 2011

Interventional Techniques in Uro‐Oncology

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The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Cited by 345 publications

References 36 publications

Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

Imaging in Diagnosis and Staging of Urological Cancers: Ultrasound, CT, and PET

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The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Cited by 345 publications

References 36 publications

Evaluation of Hybrid 68Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Evaluation of Hybrid 68Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Clinical impact of 18F-choline PET/CT in patients with recurrent prostate cancer

Imaging in Diagnosis and Staging of Urological Cancers: Ultrasound, CT, and PET

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Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy

Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy