The value of 18F-PSMA-1007 PET/CT in identifying non-metastatic high-risk prostate cancer

Hong, Junjie; Liu, Bo-le; Wang, Zhiqiang; Tang, Kun; Yin, Weiwei; Lin, Jie; Zheng, Xiujuan

doi:10.1186/s13550-020-00730-1

Cited by 22 publications

(51 citation statements)

References 24 publications

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“…Further, a higher primary tumour SUVmax was confirmed in the high-risk group compared to the intermediate-risk group. Two smaller [ 18 F]PSMA-1007 studies [ 33 , 34 ] and a similar [ 68 Ga]Ga-PSMA-11 study [ 35 ] have shown a similar correlation with higher SUVmax of the primary prostate tumour with increasing PSA levels and Gleason score/ISUP grade. In cases when a prostate biopsy cannot be performed due to patient preference or contraindications, the SUVmax of the primary tumour on the [ 18 F]PSMA-1007 PET/CT may be indirectly used to estimate ISUP grade with higher SUVmax values implying a likelihood of a high ISUP grade.…”

Section: Discussionmentioning

confidence: 83%

Risk of metastatic disease using [18F]PSMA-1007 PET/CT for primary prostate cancer staging

et al. 2021

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Background Accurate prostate cancer imaging is critical for patient management. Multiple studies have demonstrated superior diagnostic accuracy of [68Ga]-PSMA-11 PET/CT over conventional imaging for disease detection, with validated clinical and biochemical predictors of disease detection. More recently [18F]PSMA-1007 offers theoretical imaging advantages, but there is limited evidence of clinical and biochemical predictors of scan findings in the staging population. This study investigates the association of clinical variables with imaging characteristics among patients who underwent [18F]PSMA-1007 PET/CT for primary staging of men with histopathologically confirmed prostate carcinoma. A retrospective review of 194 consecutive patients imaged between May 2019 to May 2020 was performed. Association between imaging variables (presence and distribution of metastatic disease, primary tumour SUVmax) and clinical variables (EAU risk criteria) were assessed using descriptive statistics, logistic regression model and ROC analysis. Results The median age, PSA level and ISUP grade were 70 years, 10 ng/mL and ISUP grade 3, respectively. There were 36.6% of patients with intermediate-risk and 60.8% of patients with high-risk disease. ISUP grade was associated with the presence of metastasis overall (p = 0.008) as well as regional nodal (p = 0.003), non-regional nodal (p = 0.041) and bone (p = 0.006) metastases. PSA level was associated with metastatic disease overall (p = 0.001), regional (p = 0.001) and non-regional nodal metastases (p = 0.004), but not with bone metastases (p = 0.087). There were too few visceral metastases for meaningful analysis. SUVmax of the primary prostatic tumour was associated with ISUP grade (p = 0.004), PSA level (p < 0.001) and AJCC stage (p = 0.034). PSA > 20 ng/mL and ISUP grade > 3 had a specificity of 85% (95% CI 78–91%) and 60% (95% CI 50–68%) and a sensitivity of 36% (95% CI 25–49%) and 62% (95% CI 49–74%), respectively, for detection of metastatic disease. Conclusion Metastatic disease according to [18F]PSMA-1007 PET/CT was associated with ISUP grade and PSA level. This is the largest study using [18F]PSMA-1007 PET/CT to confirm a positive correlation of PSA level, ISUP grade and stage with primary prostate tumour SUVmax.

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Section: Discussionmentioning

confidence: 83%

Risk of metastatic disease using [18F]PSMA-1007 PET/CT for primary prostate cancer staging

et al. 2021

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“…The differentiation between 68 Ga-PSMA positive and negative scans was not statistically significant (mean PSA: 8.39 ± 23 vs. 4.22 ± 5.99 ng/mL, median PSA: 2.71 vs. 1.40 ng/mL, n.s.). The detection efficacy in the patient group Ga-RP was 75% (12) for PSA levels of 0.2 to <0.5 ng/mL, 86.7% (13), 76.9% (10), 94.4% (17), and 88.9% (24) for PSA levels of 0.5 to <1, 1 to < 2, 2 to < 5, and ≥5 ng/mL, respectively (p = 0.108) (Table 6). All of the 28 BCR patients in the F-RT patient group showed a positive 18 F-PSMA scan (100%) (mean PSA 9.10 ± 10.16 ng/mL) with 15 patients with PSA levels of 2 to <5 ng/mL and 13 patients with PSA values of ≥5 ng/mL, respectively.…”

Section: Positivity Rate With [ 68 Ga]ga-psma-11 Pet/ct In Patients W...mentioning

confidence: 98%

Comparison of [18F]PSMA-1007 with [68Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse

Hoffmann

Eyben²,

Fischer

et al. 2022

Cancers

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This study aimed to compare the diagnostic performance of [18F]PSMA-1007 positron emission tomography/computed tomography (PET/CT) (18F-PSMA) and [68Ga]Ga-PSMA-11 PET/CT (68Ga-PSMA) by identifying prostate-specific antigen (PSA) threshold levels for optimal detecting recurrent prostate cancer (PC) and to compare both methods. Retrospectively, the study included 264 patients. The performances of 18F-PSMA and 68Ga-PSMA in relation to the pre-scan PSA were assessed by receiver operating characteristic (ROC) curve. 18F-PSMA showed PC-lesions in 87.5% (112/128 patients), while 68Ga-PSMA identified them in 88.9% (121/136). For 18F-PSMA biochemical recurrent (BCR) patients treated with radical prostatectomy (78/128, patient group: F-RP), a PSA of 1.08 ng/mL was found to be the optimal cut-off level for predicting positive and negative scans (AUC = 0.821; 95%, CI: 0.710–0.932), while for prostatectomized 68Ga-PSMA BCR-patients (89/136, patient group: Ga-RP), the cut-off was 1.84 ng/mL (AUC = 0.588; 95%, CI: 0.410–0.766). In patients with PSA < 1.08 ng/mL (F-RP) 76.3% and <1.84 ng/mL (Ga-RP) 78.6% scans were positive, whereas patients with PSA ≥ 1.08 ng/mL (F-RP) or 1.84 ng/mL (Ga-RP) had positive scan results in 100% and 91.5% (p < 0.001/p = 0.085). The identified PSA thresholds for PSMA-mappable PC lesions in BCR-patients (RP) showed a better separation for 18F-PSMA with regard to the distinguishing of positive and negative PC-lesions compared to 68Ga-PSMA. However, the two PSMA PET/CT tracers gave similar overall findings.

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“…Further, a higher primary tumour SUVmax was con rmed in the high-risk group compared to the intermediate-risk group. Two smaller [ 18 F]PSMA-1007 studies [22,23] and a similar [ 68 Ga]Ga-PSMA-11 study [24] have shown a similar correlation with higher SUVmax of the primary prostate tumour with increasing PSA levels and Gleason score/ISUP grade. In cases when a prostate biopsy cannot be performed due to patient preference or contraindications, the SUVmax of the primary tumour on the [ 18 F]PSMA-1007 PET/CT may be indirectly used to estimate ISUP grade with higher SUVmax values implying a likelihood of a high ISUP grade.…”

Section: Discussionmentioning

confidence: 80%

Risk of Metastatic Disease Using [18F]PSMA-1007 PET/CT for Primary Prostate Cancer Staging

Chikatamarla¹,

Okano²,

Jenvey³

et al. 2021

Preprint

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Purpose: Accurate prostate cancer imaging is critical for patient management. Multiple studies have demonstrated superior diagnostic accuracy of [68Ga]-PSMA-11 PET/CT over conventional imaging for disease detection, with validated clinical and biochemical predictors of disease detection. More recently [18F]PSMA-1007 offers theoretical imaging advantages, but there is limited evidence of clinical and biochemical predictors of scan findings in the staging population. This study investigates the correlation of clinical variables with imaging characteristics among patients who underwent [18F]PSMA-1007 PET/CT for primary staging of men with histopathologically confirmed prostate carcinoma. Methods: A retrospective review of 194 consecutive patients imaged between May 2019 to May 2020 was performed. Imaging performance (presence and distribution of metastatic disease, primary tumour avidity) was assessed considering clinical variables (EAU risk criteria) with logistic regression and ROC curve analysis. Results: ISUP grade was associated with the presence of metastasis overall (p=0.008) as well as regional nodal (p = 0.003), non-regional nodal (p = 0.041) and bone (p = 0.006) metastases. PSA level was associated with metastatic disease overall (p=0.001), regional (p = 0.001) and non-regional nodal metastases (p = 0.004), but not with bone metastases (p = 0.087). There were too few visceral metastases for meaningful analysis. SUVmax of the primary prostatic tumour was associated with ISUP grade (p = 0.004), PSA level (p < 0.001) and AJCC stage (p = 0.034). PSA > 20 ng/mL and ISUP grade > 3 had a specificity of 85% (95% CI 78-91%) and 60% (95% CI 50-68%), and a sensitivity of 36% (95% CI 25-49%) and 62% (95% CI 49-74%) respectively, for detection of metastatic disease.Conclusion: Metastatic disease according to [18F]PSMA-1007 PET/CT was associated with ISUP grade and PSA level. This is the largest study using [18F]PSMA-1007 PET/CT to confirm a positive correlation of PSA level, ISUP grade and stage with primary prostate tumour SUVmax.

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The value of 18F-PSMA-1007 PET/CT in identifying non-metastatic high-risk prostate cancer

Cited by 22 publications

References 24 publications

Risk of metastatic disease using [18F]PSMA-1007 PET/CT for primary prostate cancer staging

Risk of metastatic disease using [18F]PSMA-1007 PET/CT for primary prostate cancer staging

Comparison of [18F]PSMA-1007 with [68Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse

Risk of Metastatic Disease Using [18F]PSMA-1007 PET/CT for Primary Prostate Cancer Staging

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