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Could 68-Ga PSMA PET/CT become a new tool in the decision-making strategy of prostate cancer patients with biochemical recurrence of PSA after radical prostatectomy? A preliminary, monocentric series

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Abstract

Aim

To evaluate the impact of gallium68 PSMA-11 (HBED-CC)-PET/CT on decision-making strategy of patients with relapsing prostate cancer (PC) presenting a second biochemical relapse after radical prostatectomy (RP) and salvage RT or salvage androgen deprivation therapy (ADT).

Materials and methods

40 patients were retrospectively analyzed. All of them had received prostatectomy. Thirteen out of 40 were addressed to gallium68 PSMA-11 (HBED-CC)-PET/CT for a biochemical relapse after RP, 14/40 after a salvage RT and 13/40 after salvage or adjuvant ADT. The PSA level ranged between 0.1 and 1.62 ng/ml (median value: 0.51 ng/ml). We studied the impact on the decision-making process of a multidisciplinary tumor board of additional data obtained from gallium68 PSMA-11 (HBED-CC)-PET/CT.

Results

Thirty-one out of 40 evaluated patients showed positive findings at gallium68 PSMA-11 (HBED-CC)-PET/CT (77.5%). Of them, five were positive in the prostatic bed, nine in the pelvic nodes, twelve in nodes outside the pelvis and eight at bone level. Nine patients presented two different sites of relapse (22.5%). Gallium68 PSMA-11 (HBED-CC)-PET/CT data changed the therapeutic approach in 28 patients (70%).

Conclusions

Gallium68 PSMA-11 (HBED-CC)-PET/CT can be a useful tool in the restaging of post-RP, RT or ADT patients presenting biochemical relapse of PC and it could change the decision-making process in up of 70% of these patients. Prospective, larger series are needed to establish the correct role of this very promising tool in the staging and therapeutic approach of PC patients.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Radiation Oncology Department, Centre Hospitalier Régional Universitaire Jean Minjoz-INSERM U1098 EFS/BFC, Besançon, France

    Berardino De Bari

  2. Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Rosario Mazzola, Dario Aiello, Sergio Fersino, Fabiana Gregucci & Filippo Alongi

  3. Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Cefalù, Italy

    Pierpaolo Alongi

  4. Medical Oncology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Maurizio Nicodemo

  5. Division of Urology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Stefano Cavalleri

  6. Nuclear Medicine, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Matteo Salgarello

  7. University of Brescia, Brescia, Italy

    Filippo Alongi

Authors
  1. Berardino De Bari
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  2. Rosario Mazzola
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  3. Dario Aiello
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  4. Sergio Fersino
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  5. Fabiana Gregucci
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  6. Pierpaolo Alongi
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  7. Maurizio Nicodemo
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  8. Stefano Cavalleri
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  9. Matteo Salgarello
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  10. Filippo Alongi
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Corresponding author

Correspondence to Rosario Mazzola.

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The authors declare that they have no conflict of interest.

Ethical standard

All procedures were in accordance with the ethical standards and the Helsinki declaration. All the patients gave their informed consent prior to inclusion in the study.

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De Bari, B., Mazzola, R., Aiello, D. et al. Could 68-Ga PSMA PET/CT become a new tool in the decision-making strategy of prostate cancer patients with biochemical recurrence of PSA after radical prostatectomy? A preliminary, monocentric series. Radiol med 123, 719–725 (2018). https://doi.org/10.1007/s11547-018-0890-7

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  • DOI: https://doi.org/10.1007/s11547-018-0890-7

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