Clinical value of negative 68 Ga-PSMA PET/CT in the management of biochemical recurrent prostate cancer patients

To evaluate the clinical value of Ga-PSMA PET/CT negativity in patients with biochemical recurrent prostate cancer (BCR). One hundred three BCR patients (median age, 70 years; median PSA, 0.47 ng/mL) with negative Ga-PSMA PET/CT, followed up for at least 1 year, were retrospectively identified in a...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2021-01, Vol.48 (1), p.87
Main Authors: Celli, M, De Giorgi, U, Caroli, P, Di Iorio, V, Fantini, L, Rossetti, V, Foca, F, Nicolini, S, Giganti, M, Paganelli, G, Matteucci, F
Format: Article
Language:English
Subjects:
Aged
Edetic Acid - analogs & derivatives
Gallium Isotopes
Gallium Radioisotopes
Humans
Male
Neoplasm Recurrence, Local - diagnostic imaging
Oligopeptides
Positron Emission Tomography Computed Tomography
Prospective Studies
Prostatic Neoplasms - diagnostic imaging
Prostatic Neoplasms - therapy
Retrospective Studies
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Summary:To evaluate the clinical value of Ga-PSMA PET/CT negativity in patients with biochemical recurrent prostate cancer (BCR). One hundred three BCR patients (median age, 70 years; median PSA, 0.47 ng/mL) with negative Ga-PSMA PET/CT, followed up for at least 1 year, were retrospectively identified in a database of 1003 consecutive patients undergoing 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 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. 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). Ga-PSMA PET/CT negativity in early BCR patients (PSA 
ISSN:1619-7089