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[68Ga]PSMA PET/CT Improves Initial Staging and Management Plan of Patients with High-Risk Prostate Cancer

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Abstract

Purpose

In this retrospective study, we compared the diagnostic value of 68Gallium prostate-specific membrane antigen positron emission tomography computed tomography ([68Ga]PSMA PET/CT) in primary staging of patients with high-risk prostate cancer (PCa), in comparison to CT, magnetic resonance imaging (MRI), and bone scans, and we explored its overall impact on patients’ management plan.

Procedures

Patients with pathological confirmation of PCa with high-risk disease were included in this study. Information on patient demographics, clinical and histopathological findings with Gleason score and initial prostate specific antigen PSA levels, and radiological findings for CT, MRI, bone scan, and [68Ga]PSMA PET/CT were retrieved. We stratified the concordance and discordance of each imaging modality on per-patient and per-lesion-site bases.

Results

Twenty-one patients with high-risk disease were included in this study. [68Ga]PSMA PET/CT revealed a significantly higher concordance rate (90 %) compared to the concordance rates of bone scan (75 %), MRI (73 %), and CT (60 %). [68Ga]PSMA PET/CT had a similar accuracy to MRI in detecting prostate lesions but a higher accuracy for suspicious pelvic lymph nodes (95.2 % vs. 80 %). It also superseded CT scan in detecting suspicious pelvic lymph nodes (95.2 % vs. 75 %) and extra-pelvic lymph nodes (100 % vs. 75 %), as well as bone lesions via bone scan (100 % vs. 62.5 %). [68Ga]PSMA PET/CT changed the management in 11 patients (52 %).

Conclusions

[68Ga]PSMA PET/CT is an invaluable imaging modality in the assessment of primary high-risk PCa with great potential for the detection of lymph node spread and bone metastases that would impact the management plan.

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Acknowledgments

Authors would like to acknowledge and thank the Office of Scientific and Academic Research (OSAR) at KHCC, particularly Mrs. Dalia Al-Rimawi for her work on the statistical analyses of the data.

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Authors and Affiliations

  1. Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan

    Nader Hirmas, Akram Al-Ibraheem, Abedalatif Alsharif & Haider Muhsin

  2. Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany

    Ken Herrmann

  3. Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan

    Jamal Khader

  4. Department of Uro-Oncology Surgery, King Hussein Cancer Center, Amman, Jordan

    Ali Al-Daghmin

  5. Department of Hematology and Medical Oncology, King Hussein Cancer Center, Amman, Jordan

    Samer Salah

Authors
  1. Nader Hirmas
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  2. Akram Al-Ibraheem
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  3. Ken Herrmann
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  4. Abedalatif Alsharif
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  5. Haider Muhsin
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  6. Jamal Khader
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  7. Ali Al-Daghmin
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  8. Samer Salah
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Correspondence to Akram Al-Ibraheem.

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The authors declare that they have no conflict of interest.

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Hirmas, N., Al-Ibraheem, A., Herrmann, K. et al. [68Ga]PSMA PET/CT Improves Initial Staging and Management Plan of Patients with High-Risk Prostate Cancer. Mol Imaging Biol 21, 574–581 (2019). https://doi.org/10.1007/s11307-018-1278-8

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  • DOI: https://doi.org/10.1007/s11307-018-1278-8

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