Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Luiting, Henk B.; Leeuwen, Pim J. van; Busstra, Martijn B.; Brabander, Tessa; Poel, Henk G. van der; Donswijk, Maarten L.; Vis, André N.; Emmett, Louise; Stricker, Phillip D.; Roobol, Monique J.

doi:10.1111/bju.14944

Cited by 89 publications

(70 citation statements)

References 68 publications

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“…A just published comprehensive literature search [ 28 ], including nine retrospective and two prospective studies, reported detection rates of [ 68 Ga]Ga-PSMA-PET in recurrent patients for PSA <0.2 ng/mL, for 0.2–0.49 ng/mL, and for PSA 0.5 to <1.0 ng/mL ranged from 11% to 50%, 20% to 73%, and 25% to 88%. Our results match those of Luiting et al We had LPR values of 27% for 0.2 to <0.5 ng/mL and 32% for 0.5 to <1.0 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

“…The subgroup of patients with PSA < 0.2 ng/mL was excluded in our study, because they do not belong to BC patients per definition [ 15 ]. The authors [ 28 ] observed high specificity rates of [ 68 Ga]Ga-PSMA-PET imaging for pelvic LNM detection in primary staging as well as in restaging, while sensitivity was modest, and they concluded that [ 68 Ga]Ga-PSMA PET has a high impact in patient management concerning the salvage setting [ 11 , 28 , 29 ]. In our study, we found LNM in 70% of the PSMA-avid metastases, 78% of which were pelvic LNM in restaging patients (P-P).…”

Section: Discussionmentioning

confidence: 99%

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Dual-Time Point [68Ga]Ga-PSMA-11 PET/CT Hybrid Imaging for Staging and Restaging of Prostate Cancer

Hoffmann

Buchholz²,

Wieler

et al. 2020

Cancers

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Routine [68Ga]Ga-PSMA-11 PET/CT (one hour post-injection) has been shown to accurately detect prostate cancer (PCa) lesions. The goal of this study is to evaluate the benefit of a dual-time point imaging modality for the staging and restaging of PCa patients. Biphasic [68Ga]Ga-PSMA-11 PET/CT of 233 patients, who underwent early and late scans (one/three hours post-injection), were retrospectively studied. Tumor uptake and biphasic lesion detection for 215 biochemically recurrent patients previously treated for localized PCa (prostatectomized patients (P-P)/irradiated patients (P-I) and 18 patients suspected of having primary PCa (P-T) were separately evaluated. Late [68Ga]Ga-PSMA-11 PET/CT imaging detected 554 PCa lesions in 114 P-P patients, 187 PCa lesions in 33 P-I patients, and 47 PCa lesions in 13 P-T patients. Most patients (106+32 P-P/P-I, 13 P-T) showed no additional PCa lesions. However, 11 PSMA-avid lesions were only detected in delayed images, and 33 lesions were confirmed as malignant by a SUVmax increase. The mean SUVmax of pelvic lymph node metastases was 25% higher (p < 0.001) comparing early and late PET/CT. High positivity rates from routine [68Ga]Ga-PSMA-11 PET/CT for the staging and restaging of PCa patients were demonstrated. There was no decisive influence of additional late imaging with PCa lesion detection on therapeutic decisions. However, in a few individual cases, additional delayed scans provided an information advantage in PCa lesion detection due to higher tracer uptake and improved contrast.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dual-Time Point [68Ga]Ga-PSMA-11 PET/CT Hybrid Imaging for Staging and Restaging of Prostate Cancer

Hoffmann

Buchholz²,

Wieler

et al. 2020

Cancers

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“…Our own data confirmed that 68 Ga‐PSMA has higher detection rate in both lymph node metastases and seminal vesicle metastatic involvement than 11 C‐acetate PET in high‐risk patients. In an overview of nine retrospective and two prospective studies, the specificity of 68 Ga‐PSMA PET/CT in detecting pelvic lymph node metastases before initial treatment was 33.3‐100% and 80‐100%, respectively. The authors concluded that due to the moderate sensitivity, 68 Ga‐PSMA PET/CT cannot yet replace pelvic lymph node dissection to exclude metastases.…”

Section: Stagingmentioning

confidence: 99%

Current status of PSMA PET imaging in prostate cancer

Ho¹,

Wu²,

Chen³

2020

Asia-Pac J Clncl Oncology

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The past decade has witnessed the rising popularity and acceptance of molecular definitions on disease management. Prostate‐specific membrane antigen (PSMA), in light of its molecular nature and cytokinetic properties, has rapidly become the target for development of a variety of functional tracers for PET/CT evaluation of prostate cancer. The most commonly used PSMA‐binding analog is 68Ga‐labeled PSMA‐11, which is now widely applied in both research and clinical settings. Literature data in the recent years have been enriched by a number of meta‐analyses and systemic reviews on the evolving role of PSMA PET in primary diagnosis, staging, detection of biochemical recurrence after primary cancer treatment, identification, and significance of oligometastasis, as well as in restaging and treatment monitoring. Being a highly sensitive and reasonably specific molecular tracer, PSMA‐binding analogs have a high potential to possess the majority of imaging characteristics required for a variety of management decisions in prostate malignancy.

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“…Presurgical computerized tomography (CT) scan or magnetic resonance imaging (MRI) is helpful for LN staging, but with limited accuracy [10].…”

Section: Introductionmentioning

confidence: 99%

Can 68Ga-prostate specific membrane antigen positron emission tomography / computerized tomography provide an accurate lymph node staging for patients with medium / high risk prostate cancer? A Diagnostic Meta-Analysis

Peng

Meng

et al. 2020

Preprint

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Objective: This article aims to evaluate the diagnostic value of 68Gallium-PSMA positron emission tomography/computerized tomography (68Ga-PSMA PET/CT) for lymph node (LN) staging in patients with prostate cancer (PCa) by a meta-analysis of diagnostic tests.Methods: We systematically retrieved articles from Web of Science, EMBASE, Cochrane Database, PubMed. The time limit is from the creation of the database until June 2019, and Stata 15 was used for calculation and statistical analyses.Results: Sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR) and 95% confidence intervals (CI) be used to evaluate the diagnostic value. A total of 10 studies were included in our meta-analysis, which included 701 individuals. The results of each consolidated summary are as follows: sensitivity of 0.84 (95% CI: 0.55-0.95), specificity of 0.95 (95% CI: 0.87-0.98), PLR and NLR was 17.19 (95% CI: 6.27, 47.17) and 0.17 (95% CI: 0.05-0.56), respectively. DOR of 100 (95% CI: 18-545), AUC of 0.97 (95% CI: 0.95-0.98). Conclusion: Our study demonstrates that 68Ga-PSMA PET/CT has a high overall diagnostic value for LN staging in patients with moderate and high-risk PCa. But our conclusions still require a larger sample size, multi-center prospective randomized controlled trial to verify.

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Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Cited by 89 publications

References 68 publications

Dual-Time Point [68Ga]Ga-PSMA-11 PET/CT Hybrid Imaging for Staging and Restaging of Prostate Cancer

Dual-Time Point [68Ga]Ga-PSMA-11 PET/CT Hybrid Imaging for Staging and Restaging of Prostate Cancer

Current status of PSMA PET imaging in prostate cancer

Can 68Ga-prostate specific membrane antigen positron emission tomography / computerized tomography provide an accurate lymph node staging for patients with medium / high risk prostate cancer? A Diagnostic Meta-Analysis

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