Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology, and/or urology met on February 21, 2020, in Amsterdam, The Netherlands, to formulate criteria for PSMA PET/CT-based response in patients treated for metastatic PCa and optimal timing to use it.
Panelists received thematic topics and relevant literature prior to the meeting. Statements on how to interpret response and progression on therapy in PCa with PSMA PET/CT and when to use it were developed. Panelists voted anonymously on a nine-point scale, ranging from strongly disagree (1) to strongly agree (9). Median scores described agreement and consensus.
PSMA PET/CT consensus statements concerned utility, best timing for performing, criteria for evaluation of response, patients who could benefit, and handling of radiolabeled PSMA PET tracers. Consensus was reached on all statements. PSMA PET/CT can be used before and after any local and systemic treatment in patients with metastatic disease to evaluate response to treatment. Ideally, PSMA PET/CT imaging criteria should categorize patients as responders, patients with stable disease, partial response, and complete response, or as non-responders. Specific clinical scenarios such as oligometastatic or polymetastatic disease deserve special consideration.
Adoption of PSMA PET/CT should be supported by indication for appropriate use and precise criteria for interpretation. PSMA PET/CT criteria should categorize patients as responders or non-responders. Specific clinical scenarios deserve special consideration.
European journal of nuclear medicine and molecular imaging. 2020 Jul 02 [Epub ahead of print]
Stefano Fanti, Karolien Goffin, Boris A Hadaschik, Ken Herrmann, Tobias Maurer, Steven MacLennan, Daniela E Oprea-Lager, Wim Jg Oyen, Olivier Rouvière, Nicolas Mottet, Anders Bjartell
Nuclear Medicine Division, Policlinico S Orsola, University of Bologna, Bologna, Italy., Department of Nuclear Medicine and Molecular Imaging, University Hospital Leuven and KU Leuven, Leuven, Belgium., Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany., Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany., Department of Urology and Martini-Klinik Prostate Cancer Center, Universitätsklinikum, Hamburg-Eppendorf, Hamburg, Germany., Academic Urology Unit, University of Aberdeen, Foresterhill, Aberdeen, UK., Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands., Humanitas University and Humanitas Clinical and Research Center, Milan, Italy., Department of Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France., University Hôpital Nord, Saint Etienne, France., Department of Urology, Skåne University Hospital, Malmö, Sweden. .