Scientific Online Resource System

Varna Medical Forum

Parameters of the Hybrid Method [68Ga]PSMA PET/CT in Different Diagnostic Groups of Patients

Marina Dyankova, Tanya Stoeva, Zhivka Dancheva, Sofiya Chausheva, Tsvetelina Yordanova, Borislav Chaushev, Aneliya Klisarova

Abstract

Introduction/ Aim: The aim of our study was to assess the parameters of the hybrid imaging method 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET/CT): detection rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in different diagnostic groups of patients.

Materials and Methods: We analyzed retrospectively and included in the study a total of 386 patients diagnosed with prostate cancer (PC) in the period 07.2019–01.2021, based on defined inclusion criteria. The patients were divided into four groups: 133 with biochemical recurrence (BHR) after radical therapy (group I); 144 with biochemical progression after radical prostatectomy (RP) (group II); 109 referred for staging of primary PC (group III); and 61 with high-risk PC (group IV).

Results and discussion: We reported high specificity (from 97.7% to 100.0%) and PPV (from 98.9% to 100.0%) in all studied diagnostic groups of patients. We reported high values for the sensitivity of the hybrid imaging method in all diagnostic groups of patients (from 92.3% to 98.9%), with lower values found in patients with ISUP grade 5 (group IV) (92.3%) compared to other groups (from 95.3% to 98.9%). NPV was reported from 69.2% to 97.7%, with lower values shown by patients in group IV (69.2%) compared to the first three groups of patients (from 97.1% to 98.8%). The accuracy of the method in all studied groups of patients was reported as high: from 93.4% to 99.3%. Patients with ISUP grade 5 had relatively lower values (93.4%) when compared to other groups (98.2%–99.3%).

Conclusion: 68Ga-PSMA PET/CCT is a highly promising imaging modality for PC detection in BHR and staging of primary PC, demonstrating high parametric data in all studied groups of patients. Patients with ISUP grade 5 have the highest detection rate, while other parameters in the same group (NPV, sensitivity, and accuracy) have relatively lower values.


Keywords

68Ga-PSMA PET/CT, parameters, prostate cancer

Full Text


References

Afshar-Oromieh A, Avtzi E, Giesel FL, Holland-Letz T, Linhart HG, Eder M et al. The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2015; 42: 197–209. https://doi.org/10.1007/s00259-014-2949-6 2. Afshar-Oromieh A, Holland-Letz T, Giesel FL, Kratochwil C, Mier W, Haufe S et al. Diagnostic performance of (68)Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J Nucl Med Mol Imaging. 2017; 44:1258-1268. https://doi.org/10.1007/s00259-017-3711-7 3. Bluemel C, Linke F, Herrmann K, Simunovic I, Eiber M, Kestler C et al. Impact of (68)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy. Eur J Nuc Med Mol Imaging. 2016, 6: 78. https://dx.doi.org/10.1186%2Fs13550-016-0233-4 4. Bluemel C, Krebs M, Polat B, Linke F, Eiber M, Samnick S et al. 68Ga-PSMA-PET/CT in patients with biochemical prostate cancer recurrence and negative 18F-choline-PET/CT. Clin Nucl Med. 2016;41:515-521. https://doi.org/10.1097/rlu.0000000000001197 5. Budaus L, Leyh-Bannurah SR, Salomon G, Michl U, Heinzer H, Huland H et al. Initial Experience of (68)Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy. Eur Urol. 2016, 69: 393-396. https://doi.org/10.1016/j.eururo.2015.06.010 6. Ceci F, Uprimny C, Nilica B, Geraldo L, Kendler D, Kroiss A et al. 68Ga-PSMA PET/CT for restaging recurrent prostate cancer: which factors are associated with PET/CT detection rate? Eur J Nucl Med Mol Imaging. 2015; 42(8): 1284-1294. https://doi.org/10.1007/s00259-015-3078-6 7. Clarebrough E, Duncan C, Christidis D, Lavoipierre A, Lawrentschuk N. PSMA-PET guided hook-wire localization of nodal metastases in prostate cancer: A targeted approach. World J Urol. 2018; 37(7): 1251-1254. https://doi.org/10.1007/s00345-018-2282-y 8. Eiber M, Maurer T, Souvatzoglou M, Beer AJ, Ruffani A, Haller B et al. Evaluation of hybrid 68Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. 2015; 56 (5): 668–674. https://doi.org/10.2967/jnumed.115.154153 9. Emmett L, van Leeuwen PJ, Nandurkar R, Scheltema MJ, Cusick T, Hruby G et al. Treatment outcomes from (68)Ga-PSMA PET/CT-informed salvage radiation treatment in men with rising PSA after radical prostatectomy: prognostic value of a negative PSMA PET. J Nucl Med. 2017.58: 1972-1976. https://doi.org/10.2967/jnumed.117.196683 10. Farolfi A, Ceci F, Castellucci P,Graziani T, Siepe G, Lambertini A et al. 68Ga-PSMA-11 PET/CT in prostate cancer patients with biochemical recurrence after radical prostatectomy and PSA <0.5 ng/ml. Efficacy and impact on treatment strategy. Eur J Nucl Med Mol Imaging. 2019; 46, 11–19. https://doi.org/10.1007/s00259-018-4066-4 11. Fendler WP, Calais J, Eiber M, Flavell RR, Mishoe A, Feng FY et al. Assessment of 68Ga-PSMA-11 PET accuracy in localizing recurrent prostate cancer: a prospective single-arm clinical trial. JAMA Oncol. 2019; 5:856–863. https://doi.org/10.1001/jamaoncol.2019.0096 12. Grubmuller B, Baltzer P, D’Andrea D, Korn S, Haug AR, Hacker M et al. (68)Ga-PSMA 11 ligand PET imaging in patients with biochemical recurrence after radical prostatectomy—diagnostic performance and impact on therapeutic decision-making. Eur J Nucl Med Mol Imaging. 2018; 45:235–242. https://doi.org/10.1007/s00259-017-3858-2 13. Herlemann A, Wenter V, Kretschmer A, Thierfelder KM, Bartenstein P, Faber C et al. (68)Ga-PSMA positron emission tomography/computed tomography provides accurate staging of lymph node regions prior to lymph node dissection in patients with prostate cancer. Eur Urol. 2016, 70: 553-557. https://doi.org/10.1016/j.eururo.2015.12.051 14. Hijazi S, Meller B, Leitsmann C, Strauss A, Meller J, Ritter CO et al. Pelvic lymph node dissection for nodal oligometastatic prostate cancer detected by Ga-68-PSMA-positron emission tomography/computerized tomography. Prostate. 2015, 75: 1934-1940. https://doi.org/10.1002/pros.23091 15. Hope TA, Truillet C, Ehman EC, Afshar-Oromieh A, Aggarwal R, Ryan CJ et al. 68Ga-PSMA-11 PET imaging of response to androgen receptor inhibition: first human experience. J Nucl Med. 2017; 58(1): 81–84. https://doi.org/10.2967/jnumed.116.181800 16. Hope TA, Goodman JZ, Allen IE , Calais J, Fendler WP, Carroll PR et al. Metaanalysis of 68Ga-PSMA-11 PET accuracy for the detection of prostate cancer validated by histopathology. J Nucl Med. 2018; 60(6): 786-793. https://doi.org/10.2967/jnumed.118.219501 17. Jilg CA, Drendel V, Rischke HC, Beck T, Vach W, Schaal K et al. Diagnostic accuracy of Ga-68- HBED-CC-PSMA-ligand-PET/CT before salvage lymph node dissection for recurrent prostate cancer. Theranostics. 2017; 7: 1770-1780. https://doi.org/10.7150/thno.18421 18. Kim SJ, Lee SW, Ha HK. Diagnostic performance of radiolabeled prostate-specific membrane antigen positron emission tomography/computed tomography for primary lymph node staging in newly diagnosed intermediate to high-risk prostate cancer patients: A systematic review and meta-analysis. Urol Int. 2018, 102: 27-36. https://doi.org/10.1159/000493169 19. Perera M, Papa N, Christidis D, Wetherell D, Hofman MS, Murphy DG et al. Sensitivity, specificity, and predictors of positive 68Ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016; 70:926-937. https://doi.org/10.1016/j.eururo.2016.06.021 20. Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I et al. Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer-updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: a systematic review and meta-analysis. Eur Urol. 2019; 77(4): 403-417. https://doi.org/10.1016/j.eururo.2019.01.049 21. Petersen LJ, Zacho HD. PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review. Cancer Imaging. 2020, 23; 20(1):10. https://doi.org/10.1186/s40644-020-0290-9 22. Pfister D, Porres D, Heidenreich A, Heidegger I, Knuechel R, Steib F et al. Detection of recurrent prostate cancer lesions before salvage lymphadenectomy is more accurate with (68)Ga-PSMA-HBED-CC than with (18)F-Fluoroethylcholine PET/CT. Eur J Nucl Med Mol Imaging. 2016; 43: 1410-1417. https://doi.org/10.1007/s00259-016-3366-9 23. Porres D, Pfister D, Thissen A, Kuru TH, Zugor V, Buettner R et al: The role of salvage extended lymph node dissection in patients with rising PSA and PET/CT scan detected nodal recurrence of prostate cancer. Prostate Cancer Prostatic Dis. 2017; 20:85-92. https://doi.org/10.1038/pcan.2016.54 24. Rauscher I, Maurer T, Beer AJ, Graner FP, Haller B, Weirich G et al. Value of 68Ga-PSMA HBED-CC PET for the assessment of lymph node metastases in prostate cancer patients with biochemical recurrence: comparison with histopathology after salvage lymphadenectomy. J Nucl Med. 2016; 57: 1713-1719. https://doi.org/10.2967/jnumed.116.173492 25. Sahlmann C, Meller B, Bouter C, Ritter CO, Ströbel P, Lotz J et al. Biphasic 68Ga-PSMA-HBED-CC-PET/CT in patients with recurrent and high-risk prostate carcinoma. Eur J Nucl Med Mol Imaging. 2016; 43: 898–905. https://doi.org/10.1007/s00259-015-3251-y 26. Von Eyben FE, Picchio M, von Eyben R, Rhee H, Bauman G. (68)Galabeled prostate-specific membrane antigen ligand positron emission tomography/computed tomography for prostate cancer: A systematic review and meta-analysis. Eur Urol Focus. 2016, 4(5): 686-693. https://doi.org/10.1016/j.euf.2016.11.002




DOI: http://dx.doi.org/10.14748/vmf.v11i0.8734

Refbacks

Font Size


|