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Molecular Imaging and Biology

, Volume 21, Issue 3, pp 574–581 | Cite as

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

  • Nader Hirmas
  • Akram Al-IbraheemEmail author
  • Ken Herrmann
  • Abedalatif Alsharif
  • Haider Muhsin
  • Jamal Khader
  • Ali Al-Daghmin
  • Samer Salah
Research Article

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 It also superseded CT scan in detecting suspicious pelvic lymph nodes (95.2 % vs. 75 %) and extra-pelvic lymph nodes (100 % vs. 75 %), as well as bone lesions via bone scan (100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.

Key words

PSMA PET/CT MRI Bone scan CT scan Theranostics High risk Prostate cancer Primary staging Nuclear medicine 

Notes

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.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

For this type of study, formal consent is not required.

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Copyright information

© World Molecular Imaging Society 2018

Authors and Affiliations

  1. 1.Department of Nuclear MedicineKing Hussein Cancer CenterAmmanJordan
  2. 2.Department of Nuclear MedicineUniversitätsklinikum EssenEssenGermany
  3. 3.Department of Radiation OncologyKing Hussein Cancer CenterAmmanJordan
  4. 4.Department of Uro-Oncology SurgeryKing Hussein Cancer CenterAmmanJordan
  5. 5.Department of Hematology and Medical OncologyKing Hussein Cancer CenterAmmanJordan

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