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68Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC): a prospective single-centre study in patients eligible for salvage therapy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Objectives

The primary objective is to assess the efficacy of 68Ga-PSMA-11-PET/CT to detect recurrent location(s) in hormone-sensitive prostate cancer (PCa). Secondary objectives are (1) to evaluate changes in clinical management; (2) to determine which covariates independently predict positive scan; (3) to assess 68Ga-PSMA-11-PET/CT performance in different settings of PSA relapse.

Materials and methods

Inclusion criteria include (1) histologically diagnosed PCa; (2) previous radical therapy; (3) proven biochemical recurrence (BCR) or biochemical persistence (BCP); (4) hormone-sensitive PCa (HSPC); (5) androgen deprivation therapy (ADT)–free for at least 6 months; (6) PSA < 1.5 ng/mL or any PSA in case of negative choline-PET/CT (n = 38). Changes in clinical management were defined by multidisciplinary tumour-board. Clinical settings were BCP (group-1, n = 25); first-time BCR (group-2, n = 121); BCR after salvage therapy (group-3, n = 77).

Results

Two hundred twenty-three (223) consecutive patients were enrolled: median PSA = 0.65 ng/mL (0.2–8.9) and median PSAdt = 9.3 months (0.4–144.6). 96.9% received RP as primary therapy. 68Ga-PSMA-11-PET/CT positivity rate was 39.9% (CI95% 33.5–46.7%). Disease confined to pelvis was detected in 23.3% of cases. At least one distant lesion was observed in 16.6% of cases. Secondary objectives are as follows: (1) changes in clinical management were observed in 34.5% of patients; (2) PSA, PSAdt and T stage > 3a were independent predictors (all p < 0.03); (3) 68Ga-PSMA-11-PET/CT positivity rate was 56% (in group 1, 36.3% in group 2, 40.3% in group 3.

Conclusion

This study attested the overall good performance of 68Ga-PSMA-11-PET/CT to detect PCa locations in HSPC patients eligible for salvage therapy, influencing the therapy management in 35.4% of cases. Furthermore, patient characteristics are influencing factors of 68Ga-PSMA-11-PET/CT positivity rate and should be considered to reduce false negative scan.

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Authors and Affiliations

  1. Nuclear Medicine, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Corso AM Dogliotti, 14, 10126, Turin, Italy

    Désirée Deandreis, Francesco Ceci, Daniele Giovanni Nicolotti, Emanuela Pilati, Roberto Passera & Marilena Bellò

  2. Radiation Oncology, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Turin, Italy

    Alessia Guarneri, Sara Bartoncini, Ramona Parise, Roberta Carlevato & Umberto Ricardi

  3. Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy

    Beatrice Lillaz, Marco Oderda, Andrea Zitella & Paolo Gontero

  4. Radiation Oncology, Department of Oncology, School of Medicine, University of Turin, Turin, Italy

    Umberto Ricardi

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  1. Désirée Deandreis
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Correspondence to Francesco Ceci.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent and local ethical committee approval

Informed consent form (ICF) was obtained from all individual participants enrolled in this prospective study. This study was approved by the local ethical committee (IRB number: P-5315).

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Deandreis, D., Guarneri, A., Ceci, F. et al. 68Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC): a prospective single-centre study in patients eligible for salvage therapy. Eur J Nucl Med Mol Imaging 47, 2804–2815 (2020). https://doi.org/10.1007/s00259-020-04809-8

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