Combined forced diuresis and late acquisition on [68Ga]Ga-PSMA-11 PET/CT for biochemical recurrent prostate cancer: a clinical practice-oriented study

Objectives Increased detection of prostate cancer (PCa) recurrences using [ 68 Ga]Ga-PSMA-11 PET/CT has been reported by adding forced diuresis or late-phase imaging to the standard protocol. However, the combination of these procedures in the clinical setting is still not standardized. Methods One...

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Published in:European radiology 2023-05, Vol.33 (5), p.3343-3353
Main Authors: Bauckneht, Matteo, Miceli, Alberto, Signori, Alessio, Albano, Domenico, Capitanio, Selene, Piva, Roberta, Laudicella, Riccardo, Franchini, Annalisa, D’Amico, Francesca, Riondato, Mattia, Chiola, Silvia, Marini, Cecilia, Fornarini, Giuseppe, Scarale, Antonio, Muni, Alfredo, Bertagna, Francesco, Burger, Irene A., Sambuceti, Gianmario, Morbelli, Silvia
Format: Article
Language:English
Subjects:
Accuracy
Computed tomography
Confidence intervals
Diagnostic Radiology
Diagnostic systems
Diuresis
Diuretics
Edetic Acid
Gallium Radioisotopes
Humans
Imaging
Internal Medicine
Interventional Radiology
Male
Medical diagnosis
Medical imaging
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local - diagnostic imaging
Neuroradiology
Nuclear Medicine
Positron emission
Positron Emission Tomography Computed Tomography - methods
Prostate cancer
Prostatic Neoplasms - diagnostic imaging
Radiology
Ultrasound
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Summary:Objectives Increased detection of prostate cancer (PCa) recurrences using [ 68 Ga]Ga-PSMA-11 PET/CT has been reported by adding forced diuresis or late-phase imaging to the standard protocol. However, the combination of these procedures in the clinical setting is still not standardized. Methods One hundred prospectively recruited biochemical recurrent PCa patients were restaged with dual-phase [ 68 Ga]Ga-PSMA-11 PET/CT from September 2020 to October 2021. All patients received a standard scan (60 min), followed by diuretics (140 min) and a late-phase abdominopelvic scan (180 min). PET readers with low ( n  = 2), intermediate ( n  = 2), or high ( n  = 2) experience rated (i) standard and (ii) standard + forced diuresis late-phase images in a stepwise fashion according to E-PSMA guidelines, scoring their level of confidence. Study endpoints were (i) accuracy against a composite reference standard, (ii) reader’s confidence level, and (iii) interobserver agreement. Results Forced diuresis late-phase imaging increased the reader’s confidence category for local and nodal restaging (both p  
ISSN:1432-1084
0938-7994
1432-1084
DOI:10.1007/s00330-023-09516-0