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Clinical value of negative 68Ga-PSMA PET/CT in the management of biochemical recurrent prostate cancer patients
Purpose To evaluate the clinical value of 68 Ga-PSMA PET/CT negativity in patients with biochemical recurrent prostate cancer (BCR). Methods One hundred three BCR patients (median age, 70 years; median PSA, 0.47 ng/mL) with negative 68 Ga-PSMA PET/CT, followed up for at least 1 year, were retrospect...
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Published in: | European journal of nuclear medicine and molecular imaging 2021, Vol.48 (1), p.87-94 |
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Main Authors: | , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Purpose
To evaluate the clinical value of
68
Ga-PSMA PET/CT negativity in patients with biochemical recurrent prostate cancer (BCR).
Methods
One hundred three BCR patients (median age, 70 years; median PSA, 0.47 ng/mL) with negative
68
Ga-PSMA PET/CT, followed up for at least 1 year, were retrospectively identified in a database of 1003 consecutive patients undergoing
68
Ga-PSMA PET/CT for BCR. Clinical recurrence (CR) was determined or excluded on follow-up imaging selected as per clinical practice. Clinical recurrence-free survival (CRFS) was computed from the date of negative
68
Ga-PSMA PET/CT to the date of evident disease; frequencies of CRFS were described as per ISUP patient subset (subset 1: ISUP grades 1 and 2; subset 2: ISUP grade 3; subset 3: ISUP grades 4 and 5) and other conventional variables.
Results
In 57 patients out of 103 (55.3%), CR was detected in the prostatic fossa (45.6%), nodes (38.6%), and bone (15.8%). The median CRFS was 15.4 months (range, 12.1–20.5), with a CRFS at 12 months in 61.4% of cases (range, 50.9–70.4) whereas the 24-month CRFS was 34.8% (range, 24–45.8). ISUP subset 1 benefited from significantly longer CRFS compared to subset 2 and subset 3 (median CRFS, 20.5 months, 12.6 months, and 12.1 months, respectively). ISUP subset 3 had significantly poorer 24-month CRFS (9.3%) compared to subset 1 (47.8%) and subset 2 (33.5%). At the univariate and multivariate analyses, the ISUP subset was the only significant risk factor for clinical relapse; ISUP subset 3 and subset 2 patients held a higher risk of CR compared to subset 1 patients (HR of 2.75 [1.35–5.57] for subset 3 versus subset 1; HR of 2.08 [1.11–3.88] for subset 2 versus subset 1).
Conclusion
68
Ga-PSMA PET/CT negativity in early BCR patients (PSA |
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ISSN: | 1619-7070 1619-7089 |
DOI: | 10.1007/s00259-020-04914-8 |