The role of 68Ga-PSMA-I&T PET/CT in the pretreatment staging of primary prostate cancer. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Meyrick, Danielle P.; Asokendaran, Marcus; Skelly, Laura A.; Lenzo, Nat P.; Henderson, Andrew
• Is Part Of: Nuclear medicine communications. Volume 38:Issue 11(2017:Nov.)
• Publication Date: 2017-11
• Subjects: 68Ga-PSMA PET/CT -- gallium-68 -- Gleason score -- lymph node metastases -- primary staging -- prostate cancer -- prostate-specific antigen -- prostate-specific membrane antigen -- PSMA-I&T -- theranostics; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000738
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Objectives: This retrospective study aimed to evaluate the role of 68 Ga-PSMA-I&T PET/CT in the primary staging of newly diagnosed prostate cancer (PCa), with a focus on the detection of metastatic nodal disease. Correlation of the rate of detection of metastatic disease by 68 Ga-PSMA-I&T PET/CT with the Gleason score (GS) and serum prostate-specific antigen (PSA) was performed to determine the GS and PSA criteria defining patients who would benefit from 68 Ga-PSMA-I&T PET/CT imaging for staging, risk stratification and therapy optimization. Patients and methods: Patient data and images from 70 patients with a recent diagnosis of prostate cancer who had undergone 68 Ga-PSMA-I&T PET/CT were analysed retrospectively. Data and images were analysed for the rate of detection of primary and metastatic PCa, and correlation with PSA and GS. Results: The rate of detection of primary tumour by 68 Ga-PSMA-I&T for patients with serum PSA less than 5 ng/ml was 73%. The corresponding rate was 90% for patients with PSA 5–10 ng/ml and 97% for patients with PSA more than 10 ng/ml. Metastatic PCa and/or infiltrative disease was detected in 24/70 study patients in total: 1/11 patients with PSA less than 5 ng/ml and 23/59 patients with serum PSA at least 5 ng/ml. The rate of detection of metastatic PCa was greater in patients with GS 9 or more (48%) relative to those with GS 8 (32%) or GS ⩽7 (18%). Conclusion: A role for 68 Ga-PSMA-I&T PET/CT in primary PCa staging of high-grade disease (GS 8 or more and PSA >10 ng/ml) has been shown. There was a low rate of detection of PSMA-avid metastases in low-grade disease (GS 7 or less and PSA <5 ng/ml), suggesting that there is a limited role for this modality in such cases.