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Impact of 18F-PSMA-11 PET/CT on Management of Biochemical Recurrence and High-Risk Prostate Cancer Staging

18F-PSMA-11 PET/CT and Impact on Prostate Cancer Management

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Abstract

Purpose

In this study, we evaluated the impact of 18F-PSMA-11 PET/CT on the patient management plan in patients with primary or recurrent disease. Furthermore, a correlation between PET findings and other modalities was performed.

Procedures

In this prospective observational study, 60 prostate cancer patients (9 primary staging, 51 biochemical recurrence) were imaged with 18F-PSMA-11 PET/CT. Pre- and post-scan questionnaires were completed by the treating physician to observe changes in therapy intent. Follow-up data (histological confirmation, MRI imaging, and PSA values after radiotherapy without implementation of systemic therapy) was correlated with the 18F-PSMA-11 findings.

Results

The patient-based detection rate was 82% and a management change was seen in 52% of the cases. The heterogeneous characteristics of the included patients resulted in a widely varying treatment change, mostly originating from an increase of disease extent on 18F-PSMA-11 PET/CT.

Conclusion

18F-PSMA-11 PET/CT showed to be a highly promising method for the detection of prostate cancer lesions.

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References

  1. N. Mottet, P. Cornford, R.C.N. van den Bergh, E. Briers, M. De Santis, S. Fanti, S.Gilessen, J. Grummet, A. M. Henry, T. B. Lam, M.D. Mason, T.H. van der Kwast, H.G. van der Poel, O. Rouvière, I.G. Schoots, D. Tilki, T. W. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on prostate cancer.

  2. Corfield J, Perera M, Bolton D, Lawrentschuk N (2018) 68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) for primary staging of high-risk prostate cancer: a systematic review. World J Urol 36:519–527

    Article  Google Scholar 

  3. Hofman MS et al (2020) Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 395:1208–1216

    Article  CAS  Google Scholar 

  4. Murthy, V. et al. Prostate-only versus whole-pelvic radiation therapy in high-risk and very high-risk prostate cancer (POP-RT): outcomes from phase III randomized controlled trial. J. Clin. Oncol. JCO.20.03282 (2021) https://doi.org/10.1200/jco.20.03282.

  5. Luiting HB et al (2020) 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. BJU Int 125:206–214

    Article  CAS  Google Scholar 

  6. Perera M et al (2020) Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer—updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: a systematic review and meta-. Eur Urol 77:403–417

    Article  Google Scholar 

  7. Kersemans K et al (2018) Automated radiosynthesis of Al[18F]PSMA-11 for large scale routine use. Appl Radiat Isot 135:19–27

    Article  CAS  Google Scholar 

  8. Piron S et al (2019) Radiation dosimetry and biodistribution of 18F-PSMA-11 for PET imaging of prostate cancer. J Nucl Med 60:1736–1742

    Article  CAS  Google Scholar 

  9. Piron, S. et al. Optimization of PET protocol and interrater reliability of 18F-PSMA-11 imaging of prostate cancer. EJNMMI Res. 10, (2020).

  10. Maurer T et al (2016) Diagnostic efficacy of 68Gallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer. J Urol 195:1436–1443

    Article  Google Scholar 

  11. Morigi JJ et al (2015) Prospective comparison of 18F-fluoromethylcholine versus 68Ga-PSMA PET/CT in prostate cancer patients who have rising PSA after curative treatment and are being considered for targeted therapy. J Nucl Med 56:1185–1190

    Article  CAS  Google Scholar 

  12. Van Leeuwen PJ et al (2016) 68Ga-PSMA has a high detection rate of prostate cancer recurrence outside the prostatic fossa in patients being considered for salvage radiation treatment. BJU Int 117:732–739

    Article  Google Scholar 

  13. Bluemel, C. et al. Impact of 68Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy. EJNMMI Res. 6, (2016).

  14. Albisinni S et al (2017) Clinical impact of 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer with rising prostate-specific antigen after treatment with curative intent: preliminary analysis o. BJU Int 120:197–203

    Article  CAS  Google Scholar 

  15. Hope TA et al (2017) Impact of 68Ga-PSMA-11 PET on management in patients with biochemically recurrent prostate cancer. J Nucl Med 58:1956–1961

    Article  CAS  Google Scholar 

  16. Afaq A et al (2018) Impact of 68 Ga-prostate-specific membrane antigen PET/CT on prostate cancer management. J Nucl Med 59:89–92

    Article  CAS  Google Scholar 

  17. Roach PJ et al (2018) The impact of 68 Ga-PSMA PET/CT on management intent in prostate cancer: results of an Australian prospective multicenter study. J Nucl Med 59:82–88

    Article  CAS  Google Scholar 

  18. Calais J et al (2018) Impact of 68 Ga-PSMA-11 PET/CT on the management of prostate cancer patients with biochemical recurrence. J Nucl Med 59:434–441

    Article  Google Scholar 

  19. Bashir U et al (2019) Impact of Ga-68-PSMA PET/CT on management in prostate cancer patients with very early biochemical recurrence after radical prostatectomy. Eur J Nucl Med Mol Imaging 46:901–907

    Article  Google Scholar 

  20. Hofman, M. S. et al. Articles Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. www.thelancet.com395, (2020).

  21. Fendler, W. P. et al. Impact of 68 Ga-PSMA-11 PET on the management of recurrent prostate cancer in a prospective single-arm clinical trial. J. Nucl. Med. jnumed.120.242180 (2020) https://doi.org/10.2967/jnumed.120.242180.

  22. Sweeney CJ et al (2015) Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med 373:737–746

    Article  CAS  Google Scholar 

  23. Somanathan H et al (2004) R: a language and environment for statistical computing. R Foundation for Statistical Computing Oecologia 15:413–448

    Google Scholar 

  24. Revelle, W. Package ‘psych’ - procedures for psychological, psychometric and personality research. R Packag. 1–358 (2015).

  25. Mangiafico, S. An R companion for the handbook of biological statistics. Rutgers Coop. Ext. 41–58 (2015).

  26. D’Amico AV et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. J Am Med Assoc 280:969–974

    Article  Google Scholar 

  27. Van den Broeck T et al (2020) Biochemical recurrence in prostate cancer: the European Association of Urology Prostate Cancer Guidelines Panel Recommendations. Eur Urol Focus 6:231–234

    Article  Google Scholar 

  28. Boschi S et al (2016) Synthesis and preclinical evaluation of an Al18F radiofluorinated GLU-UREA-LYS(AHX)-HBED-CC PSMA ligand. Eur J Nucl Med Mol Imaging 43:2122–2130

    Article  CAS  Google Scholar 

  29. Han S, Woo S, Kim YJ, Suh CH (2018) Impact of 68Ga-PSMA PET on the management of patients with prostate cancer: a systematic review and meta-analysis. Eur Urol 74:179–190

    Article  CAS  Google Scholar 

  30. Morris MJ et al (2020) Impact of PSMA-targeted imaging with 18F-DCFPyL-PET/CT on clinical management of patients (pts) with biochemically recurrent (BCR) prostate cancer (PCa): results from a phase III, prospective, multicenter study (CONDOR). J Clin Oncol 38:5501–5501

    Article  Google Scholar 

  31. Afshar-Oromieh, A. et al. Performance of [68Ga]Ga-PSMA-11 PET/CT in patients with recurrent prostate cancer after prostatectomy—a multi-centre evaluation of 2533 patients. Eur. J. Nucl. Med. Mol. Imaging 1–10 (2021) https://doi.org/10.1007/s00259-021-05189-3.

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Acknowledgements

The authors would like to thank all the participating staff members and physicians of the Department of Radiotherapy and Urology of Ghent University Hospital for the well-appreciated efforts to recruit patients for the study and for filling out an endless stream of paperwork. Also, a special word of thanks is given to the cyclotron team and nursing staff of the Department of Nuclear Medicine for the production of the radiotracer and the outstanding cooperation.

Funding

The study was supported by the Flemish foundation FWO TBM (T001517).

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Nuclear Medicine, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium

    Kathia De Man, Nick Van Laeken, Bliede Van den Broeck, Ken Kersemans & Vanessa Schelfhout

  2. Laboratory of Radiopharmacy, Ghent University, Ghent, Belgium

    Sarah Piron

  3. Department of Medical Imaging, Radiology, Ghent University Hospital, Ghent, Belgium

    Louke Delrue

  4. Department of Radiation-Oncology, Ghent University Hospital, Ghent, Belgium

    Valérie Fonteyne

  5. Department of Urology, Ghent University Hospital, Ghent, Belgium

    Nicolaas Lumen

  6. Department of Diagnostic Sciences, Ghent University, Ghent, Belgium

    Piet Ost

  7. Department of Radiation-Oncology, Iridium Network, Wilrijk, Belgium

    Piet Ost

Authors
  1. Kathia De Man
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  2. Sarah Piron
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  3. Nick Van Laeken
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  4. Louke Delrue
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  7. Bliede Van den Broeck
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  8. Ken Kersemans
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  9. Piet Ost
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  10. Vanessa Schelfhout
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Contributions

Guarantor of integrity of the entire study: KDM.

Study concepts and design: PO, KDM, NVL.

Literature research: KDM.

Clinical studies: KDM, VS, BVDB, NVL, NL, VF, PO.

Experimental studies/data analysis: KDM, VS.

Statistical analysis: SP.

Manuscript preparation: KDM, SP.

Manuscript editing: all authors.

Corresponding author

Correspondence to Kathia De Man.

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Conflict of Interest

Prof. Dr. P. Ost has received research grants from Bayer and Varian and has consulted for Janssen, Bayer, Curium, Novartis, and Ferring. Prof. Dr. N. Lumen has consulted for Bayer, Astra Zeneca, Ipsen, Janssen, and Astellas. The other authors declare that they have no conflict of interests.

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De Man, K., Piron, S., Van Laeken, N. et al. Impact of 18F-PSMA-11 PET/CT on Management of Biochemical Recurrence and High-Risk Prostate Cancer Staging. Mol Imaging Biol 24, 750–758 (2022). https://doi.org/10.1007/s11307-022-01724-2

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  • DOI: https://doi.org/10.1007/s11307-022-01724-2

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