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Relationships between serum PSA levels, Gleason scores and results of 68Ga-PSMAPET/CT in patients with recurrent prostate cancer

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Abstract

Aim

To investigate the relationship between serum PSA level, Gleason score of PCa and the outcomes of Ga68-PSMA PET/CT in patients with recurrent PCa.

Methods

A total of 109 consecutive patients (median age 71 years; range 48–89 years) who had PSA recurrence after RP and/or hormonotherapy and/or radiotherapy were included in this study. Local recurrences, lymph node metastasis (pelvic, abdominal and/or supradiaphragmatic), bone metastases (oligometastatic/multimetastatic) and other metastatic sites (lung, liver, brain, etc) were documented.

Results

In 91(83.4%) patients at least one lesion characteristic for PCa was detected by68Ga-PSMA PET/CT. The median serum total PSA (tPSA) was 6.5 (0.2–640) ng/ml.There was a significant difference between 68Ga-PSMA PET/CT positive and negative patients in terms of serum total PSA value. No statistical significance was found between positive and negative 68Ga-PSMA PET/CT findings in terms of Gleason score. Local recurrence was detected in 56 patients. whereas lymph node metastases were demonstrated in 46 patients. Pelvic nodal disease was the most frequent presentation followed by abdominal and supradiaphragmaticnodal involvement. Bone metastases [oligometastasis, (n = 20); multimetastasis, (n = 35)⦌ were also detected in 55 patients. In the ROC analysis for the study cohort, the optimal cut-off value of total serum PSA was determined as 0.67 ng/ml for distinguishing between positive and negative 68Ga-PSMA PET/CT images, with an area under curve of 0.952 (95% CI 0.911–0.993).

Conclusions

68Ga-PSMA PET/CT was found to be an effective tool for the detection of recurrent PCa. Even though no relationship was detected between the GS and 68Ga-PSMA PET/CT findings, serum total PSA values may be used for estimating the likelihood of positive 68Ga-PSMA PET/CT results.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, Ic Hastalıkları Binasi, Nukleer Tip Anabilim Dali, Istanbul, Turkey

    Yasemin Sanli, Serkan Kuyumcu, Goksel Alcin & Cüneyt Turkmen

  2. Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Oner Sanli

  3. Faculty of Health Science, Istanbul University, Istanbul, Turkey

    Fikret Buyukkaya

  4. Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Ayça İribaş & Emin Darendeliler

  5. Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Yasemin Ozluk

  6. Department of Biostatistics and Medical Informatics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Sevda Ozel Yildiz

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  1. Yasemin Sanli
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  2. Serkan Kuyumcu
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  3. Oner Sanli
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Correspondence to Yasemin Sanli.

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Sanli, Y., Kuyumcu, S., Sanli, O. et al. Relationships between serum PSA levels, Gleason scores and results of 68Ga-PSMAPET/CT in patients with recurrent prostate cancer. Ann Nucl Med 31, 709–717 (2017). https://doi.org/10.1007/s12149-017-1207-y

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  • DOI: https://doi.org/10.1007/s12149-017-1207-y

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