68Ga-prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET)/computed tomography (CT) has a high rate of detection for biochemical recurrence of prostate cancer in men previously treated with primary local therapy, according to a study published online in the Journal of Clinical Medicine.
Ismaheel O. Lawal, MBBS, from the University of Pretoria in South Africa, and colleagues used 68Ga-PSMA-11 PET/CT to examine the pattern of prostate cancer recurrence stratified by serum prostate-specific antigen (PSA) level and type of primary local treatment in a group of 247 men with biochemical recurrence after primary local therapy with radical prostatectomy or external beam radiotherapy. Patients imaged with 68Ga-PSMA-11 PET/CT were reviewed for localization of the site of prostate cancer recurrence. The site and number of lesions due to recurrence were determined at different PSA levels.
The researchers found that in 81.4 percent of patients, 68Ga-PSMA-11 PET/CT detected the site of recurrence, with a median of one lesion per patient. At PSA levels of <0.5, 0.5 to 1.0, 1.1 to 2.0, 2.1 to 5.0, and 5.0 to 10.0, 68Ga-PSMA-11 PET/CT positivity was 43.6, 75.7, 83.3, 90.0, and 95.8 percent, respectively. At all PSA levels, the most common site of recurrence was in the prostate gland/bed. In 118, 50, and 33 patients, respectively, pelvic, extrapelvic, and combined pelvic and extrapelvic sites of recurrence were seen. With increasing PSA levels, the risk for extrapelvic recurrence increased.
“68Ga-PSMA-11 PET/CT will be useful to guide the choice of salvage therapy in patients with prostate cancer recurrence,” the authors write.
Abstract/Full Text (subscription or payment may be required)
