The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature

Eissa, Ahmed; Elsherbiny, Ahmed; Coelho, Rafael F.; Rassweiler, Jens; Davis, John W.; Porpiglia, Francesco; Patel, Vipul; Prandini, Napoleone; Micali, Salvatore; Sighinolfi, Maria Chiara; Puliatti, Stefano; Rocco, B.; Bianchi, Giampaolo

doi:10.23736/s0393-2249.18.03081-3

Cited by 68 publications

(43 citation statements)

References 51 publications

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“…Moreover, this rate was 11.1% to 75% in patients who had <0.5 ng/mL serum PSA value. In this study, it was also reported that there was a significant relationship between high serum PSA values and PSMA positive focus detection, and 68 Ga-PSMA PET-CT imaging provided a change in treatment in 28.6-87.1% of the patients (18). In a study of 70 cases, conducted by Ceci et al (5) a significant relationship was found between positive focus detection in 68 Ga-PSMA PET-CT imaging and the PSA dt .…”

Section: Discussionsupporting

confidence: 55%

“…In our study, we showed that PSA levels were significantly higher in patients who had PSMA-positive lesion in 68 Ga-PSMA PET-CT compared to patients without a PSMA-positive lesion, but there was no statistically significant difference in terms of Gleason score, time to BCR and PSAdt. In a metaanalysis examining 37 investigations conducted by Eissa et al (18) the rate of focus detection was found to be 47-96.6% with 68 Ga-PSMA PET-CT imaging in patients with BCR. Moreover, this rate was 11.1% to 75% in patients who had <0.5 ng/mL serum PSA value.…”

Section: Discussionmentioning

confidence: 99%

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The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

Karyağar¹,

Dinçer²

2019

eamr

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Our study aimed to investigate the efficacy of Gallium-68 (68 Ga) prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) in terms of focus detection in the presence of biochemical recurrence (BCR) after primary curative treatment in patients with prostate cancer (PCa). Methods: This study included 34 PCa patients who underwent 68 Ga-PSMA PET-CT for BCR following radical prostatectomy (RP) or primary curative radiotherapy (RT), between August 2017-December 2018 at Okmeydanı Training and Research Hospital, Clinic of Nuclear Medicine. Results: Thirteen patients (38.2%) had RP and 21 (61.8%) had RT. PSMA-positive lesion was detected in 21 (61.7%) of 34 patients. PSMA positive lesion was present in six of 13 patients (46.1%) in the RP group and 15 of the 21 patients (71.4%) in the RT group. There was a PSMA-positive lesion in five out of 13 patients with serum prostate-specific antigen (PSA) values of 0.01-1 ng/mL, in five of eight patients with serum PSA values of 1-2 ng/mL, in four of five patients with serum PSA values of 2-5 ng/mL, and in seven of eight patients with serum PSA values of >5 ng/mL. PSA levels of PSMA-positive patients were found to be significantly higher than those of PSMA-negative, whereas PSA-positive and negative patients did not differ significantly in terms of PSA doubling time, time to BCR, and Gleason score. Conclusion: 68 Ga-PSMA PET-CT is an effective method in the diagnosis of BCR after primary curative treatment in PCa patients.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

Karyağar¹,

Dinçer²

2019

eamr

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“…Several recent studies have used PSMA‐PET for detecting neoplastic lesions in patients with biochemical recurrence of PCa. Whereas a positive correlation between the DR of PSMA‐PET and PSA serum values at the time of PET scan in patients with BRPCa has been clearly demonstrated, the correlation between DR of PSMA‐PET and PSA kinetics remains uncertain. Most of the studies investigating the possible correlation between PSMA‐PET findings and PSA kinetics have limited power, due to the relatively small numbers of patients enrolled and assessed (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…Recent evidence‐based articles have shown a positive correlation between the detection rate (DR) of PSMA‐PET and the PSA serum values at the time of PET scan in patients with biochemical recurrent PCa (BRPCa), whereas the correlation between the DR of PSMA‐PET and the PSA kinetics seems to be uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…These PSMA ligands may be radiolabelled with positron-emitters isotopes (mostly Gallium-68) to obtain PET radiopharmaceuticals, which can be used in the clinical practice. 6,7 Recent evidence-based articles have shown a positive correlation between the detection rate (DR) of PSMA-PET and the PSA serum values at the time of PET scan in patients with biochemical recurrent PCa (BRPCa), 10,11 whereas the correlation between the DR of PSMA-PET and the PSA kinetics seems to be uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

Mestre

Treglia

Ferrari

et al. 2019

Eur J Clin Investigation

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Background Serum prostate‐specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabelled prostate‐specific membrane antigen (PSMA‐PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA‐PET findings. We performed a systematic review and meta‐analysis to provide evidence‐based data in this setting. Methods A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta‐analysis to establish the detection rate (DR) of PSMA‐PET using different cut‐off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA‐PET results was performed in patients with BRPCa. Results Twelve articles were included in the systematic review, and eight articles (including about 1400 patients) were selected for the meta‐analysis. The pooled DR including 95% confidence intervals (95%CI) of PSMA‐PET in restaging prostate cancer (PCa) patients was 72% (95%CI:60%‐82%), increasing to 83% (95%CI:75%‐90%) when PSAdt was ≤6 months and decreasing to 60% (95%CI:37%‐80%) when PSAdt was >6 months, without a statistical significant difference. PSAdt ≤6 months may predict the positive result of PSMA‐PET (pooled odds ratio: 3.22; 95%CI:1.17‐8.88). Statistical heterogeneity among the included studies was found. Conclusions PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA‐PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.

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A randomised trial of [¹⁸F]PSMA‐1007‐PET/CT versus NaF‐PET/CT for staging primary prostate cancer: A trial protocol

et al. 2023

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BackgroundProstate‐specific membrane antigen (PSMA)‐positron emission tomography/contrast‐enhanced computed tomography (PET/CT) is a sensitive imaging modality for prostate cancer (PCa). Due to lack of knowledge of the patient benefit, PSMA‐PET/CT is not yet recommended in the European guidelines for staging and treatment planning of patients with newly diagnosed PCa. We will investigate the potential difference in progression‐free survival (PFS) and quality of life (QoL) of using PSMA‐PET/CT versus sodium fluoride (NaF)‐PET/CT for staging and treatment planning in patients with newly diagnosed PCa.Study DesignThis is a prospective randomised controlled multicentre trial carried out at three centres in the Region of Southern Denmark.EndpointsThe primary endpoint is PFS. Secondary endpoints are residual disease, stage migration, impact on treatment strategies, stage distribution, QoL and diagnostic accuracy measures.Patients and MethodsPatients eligible for the study have newly diagnosed unfavourable intermediate‐ or high‐risk PCa. A total of 448 patients will be randomised 1:1 into two groups: (A) a control group staged with Na[18F]F‐PET/CT and (B) an intervention group staged with [18F]PSMA‐1007‐PET/CT. A subgroup in the intervention group will have a supplementary blinded Na[18F]F‐PET/CT performed for the purpose of performing accuracy analyses. QoL will be assessed at baseline and with regular intervals (3–12 months) during the study period. Treatment decisions are achieved at multidisciplinary team conferences based on the results of the respective scans and according to current Danish guidelines.Trial RegistrationThe Regional Committees on Health Research Ethics for Southern Denmark (S‐20190161) and the Danish Medicines Agency (EudraCT Number 2021‐000123‐12) approved the study, and it has been registered on clinicaltrials.gov (Record 2020110469).

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The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature

Cited by 68 publications

References 51 publications

The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

A randomised trial of [¹⁸F]PSMA‐1007‐PET/CT versus NaF‐PET/CT for staging primary prostate cancer: A trial protocol

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The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature

Cited by 68 publications

References 51 publications

The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

The Diagnostic Power of the Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography in Biochemical Recurrence After Primary Curative Treatment in Patients with Prostate Cancer: A Single-center Experience

Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

A randomised trial of [18F]PSMA‐1007‐PET/CT versus NaF‐PET/CT for staging primary prostate cancer: A trial protocol

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A randomised trial of [¹⁸F]PSMA‐1007‐PET/CT versus NaF‐PET/CT for staging primary prostate cancer: A trial protocol