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. 2019 Oct 22;10(58):6124-6137.
doi: 10.18632/oncotarget.27239.

The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Manuela A Hoffmann  1   2   3 , Hans-Georg Buchholz  2 , Helmut J Wieler  3 , Thomas Höfner  4 , Jonas Müller-Hübenthal  5 , Ludwin Trampert  6 , Mathias Schreckenberger  2
Affiliations

The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Manuela A Hoffmann et al. Oncotarget. .

Abstract

Background: The aim of the present study is to analyze the efficacy of 68Gallium (Ga)-PSMA-11 PET/CT for detecting and localizing recurrent prostate carcinoma (PC) in patients with different prostate-specific antigen (PSA), PSA velocity (PSAvel) and doubling time (PSAdt). Results: The PR of 68Ga-PSMA-11 PET/CT showed a positive relationship with PSA levels. Even at restaging PSA-values (PSAV) of lower than 0.2 ng/ml, PR was 41%. For PSAV of 0.2-<0.5 ng/ml the PR was 45%, 62% for PSAV of 0.5-<1.0 and 72% for PSAV of 1.0-<2.0 ng/ml. The PR increased to 85% for PSAV of 2.0-<5.0 and reached 94% at PSAV of ≥5.0 ng/ml. At PSA of <1 ng/ml/y the PR of PSAvel was 50% and increased to 98% at PSA >5 ng/ml/y. No significant association was found for PSAdt. Methods: PET/CT scans of 660 patients with biochemical recurrence (BCR) after primary therapy of PC were included in the analysis. We correlated serum PSA levels, measured at the time of imaging with PSMA PET/CT-positivity rates (PR) as well as PSAvel (in 225 patients) and PSAdt (660 patients). Additionally we compared the incidence of localized disease to metastases as related to these PSA-biomarkers. Conclusion: We have shown, in a large cohort of patients, that 68Ga-PSMA-11 PET/CT is a sensitive tool for restaging PC and has a high detection efficacy, even in patients with very low PSA levels (<0.2 ng/ml). Thus 68Ga-PSMA-11 PET/CT both identify and localize recurrent disease with implications for a more direct treatment approach (localized vs. systemic therapy).

Keywords: 68Gallium-PSMA PET/CT; biochemical recurrence; positivity rate; prostate cancer; prostate-specific antigen.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that they have no conflict of interest. They have revealed to the Editors any relationships that they believe could be construed as resulting in an actual, potential, or perceived conflict of interest with regard to the manuscript submitted for review.

Figures

Figure 1
Figure 1. CT shows no bone metastasis in the symphyseal os pubis on the left.
Figure 2
Figure 2. 68Ga-PSMA-11 PET/CT shows a bone metastasis in the symphyseal os pubis on the left.
Figure 3
Figure 3. Positivity rate with respect to PSA.
Figure 4
Figure 4. Positivity rate with respect to PSAdt.
Figure 5
Figure 5. Positivity rate with respect to PSAvel.
See this image and copyright information in PMC

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