Clinical impact of (68) Ga-PSMA PET/CT in prostate cancer patients with rising PSA after treatment with curative intent: preliminary analysis of a multidisciplinary approach.

To assess the impact of (68) Ga-(HBED-CC)-PSMA (Prostate Specific Membrane Antigen) PET/CT in the clinical management of PCa patients with rising PSA after treatment with curative intent. (68) Ga-PSMA PET/CT scan is a novel molecular imaging technique in the field of prostate cancer (PCa).

131 consecutive patients were referred to our center for a (68) Ga-PSMA PET/CT in the setting of recurring prostate cancer. 11/131(8%) presented persistent PSA after radical prostatectomy, while 120/131 (92%) were referred for biochemical recurrence after surgery, radiotherapy or both. Images where performed 1 hour post-injection of 2MBq/Kg of (68) Ga-(HBED-CC)-PSMA ligand. All exams were interpreted by two experienced nuclear medicine specialists. With the results of the exam, a multidisciplinary oncology committee (MOC) reported on the treatment strategy. A positive impact in clinical management was considered if the exam determined a modification in the treatment strategy compared to MOC decision prior to PSMA.

All patients completed the exam with no adverse reactions. Median PSA at the time of the exam was 2.2ng/ml (range 0.72-6.7). Overall, (68) Ga-PSMA PET/CT detected at least one lesion suspicious of PCa in 98/131 (75%) patients. An impact in management was found in 99/131patients (76%).Main modifications included continuing surveillance (withholding hormonal therapy), hormonal manipulations, stereotaxic radiotherapy, salvage radiotherapy, salvage node dissection or salvage local treatment (prostatectomy, HIFU).

Our preliminary experience suggests that performing (68) Ga-PSMA PET/CT in PCa patients with rising PSA after treatment with curative intent can be clinically useful as it changes the treatment strategy in a significant percentage of patients. However, larger prospective trials are needed to validate our findings. This article is protected by copyright. All rights reserved.

BJU international. 2016 Dec 15 [Epub ahead of print]

S Albisinni, C Artigas, F Aoun, I Biaou, J Grosman, T Gil, E Hawaux, K Limani, F Otte, A Peltier, S Sideris, N Sirtaine, P Flamen, R van Velthoven

Department of Urology, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium., Department of Nuclear Medicine, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium., Department of Oncology, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium., Department of Radiation Oncology, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium., Department of Pathology, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium.

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