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18F-PSMA-1007 Identifies Distant Metastases in Prostate Cancer

By Daniel Tennenbaum, MD - Last Updated: December 10, 2021

For patients with prostate cancer, 18F-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography/computed tomography (PET/CT) can identify distant metastasis in prostate cancer and correlates with high-risk factors, according to a study recently published in Frontiers in Oncology.

Zhuonan Wang, from The First Affiliated Hospital of Xi’an Jiaotong University in China, and colleagues examined the predictive performance of 18F-PSMA-1007 PET/CT and clinicopathological characteristics on prostate cancer risk stratification and prediction of distant metastasis in a retrospective analysis involving 101 patients.

The researchers found that in high-risk stratification groups (total prostate-specific antigen [tPSA] >20 ng/mL, Gleason score [GS] ≥8, and tPSA >20 ng/mL and/or GS ≥8), the PET/CT parameters were all higher, with high sensitivity (86.89, 90.16, and 83.61 percent, respectively). Distant metastasis could be effectively predicted by the maximum standardized uptake (SUVmax), tPSA, and GS, with high sensitivity for SUVmax compared with tPSA and GS (90.50 percent versus 57.14 and 55.61 percent, respectively). Using a cutoff value of 29.01 ng/mL for tPSA, statistical differences were seen in the detection rate of distant metastasis between low- and high-prediction tPSA groups (50.0% versus 76.60%), which was not seen using guideline tPSA levels. In patients with tPSA between 20 and 29.01 ng/mL, 18F-PSMA-1007 PET/CT results showed that six of 15 patients did not have distant metastases. tPSA partially mediated the effect of SUVmax on primary tumors and metastasis lesions.

“We recommended that when the patient’s tPSA is higher than the prediction level, the patients might … benefit from 18F-PSMA -1007 PET/CT scan for distant metastasis detection,” the authors concluded.

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