Abstract

Background

Detection of the site of recurrence using PSMA-PET/CT is important to guide treatment in patients with biochemical recurrence of prostate cancer (PCa). The aim of this study was to evaluate the positivity rate of [18F]PSMA-1007-PET/CT in patients with biochemically recurrent PCa and identify parameters that predict scan positivity as well as the type and number of detected lesions. This monocentric retrospective study included 137 PCa patients with biochemical recurrence who underwent one or more [18F]PSMA-1007-PET/CT scans between August 2018 and June 2019. PET-positive malignant lesions were classified as local recurrence, lymph node (LN), bone or soft tissue lesions. The association between biochemical/paraclinical parameters, as PSA value, PSA doubling time, PSA velocity, Gleason score (GS) and androgen deprivation therapy (ADT), and scan positivity as well as type and number of detected lesions was evaluated using logistic regression analysis (binary outcomes) and Poisson models (count-type outcomes).

Results

We included 175 [18F]PSMA-1007-PET/CT scans after radical prostatectomy (78%), external beam radiation therapy (8.8%), ADT (7.3%), brachytherapy (5.1%) and high intensity focused ultrasound (0.7%) as primary treatment (median PSA value 1.6 ng/ml). Positivity rate was 80%. PSA value and PSA velocity were significant predictors of scan positivity as well as of the presence of bone and soft tissue lesions and number of bone, LN and soft tissue lesions, both in uni- and/or multivariable analysis. Multivariable analysis also showed prior ADT as predictor of bone and soft tissue lesions, GS as predictor of the number of bone lesions and ongoing ADT as predictor of the number of LN lesions.

Conclusion

[18F]PSMA-1007-PET/CT showed a high positivity rate in patients with biochemically recurrent PCa. PSA value and PSA velocity were significant predictors of scan positivity as well as of the presence and number of bone and soft tissue lesions and the number of LN lesions. Our findings can guide clinicians in optimal patient selection for [18F]PSMA-1007-PET/CT and support further research leading to the development of a prediction nomogram.

Details

Title
Parameters predicting [18F]PSMA-1007 scan positivity and type and number of detected lesions in patients with biochemical recurrence of prostate cancer
Author
Ahmadi, Bidakhvidi Niloefar 1   VIAFID ORCID Logo  ; Laenen Annouschka 2 ; Sander, Jentjens 1 ; Deroose, Christophe M 3 ; Koen, Van Laere 3 ; De Wever Liesbeth 4 ; Mai, Cindy 4 ; Charlien, Berghen 5 ; De Meerleer Gert 6 ; Haustermans Karin 6 ; Joniau Steven 7 ; Everaerts Wouter 7 ; Goffin Karolien 3 

1  University Hospitals Leuven, Department of Nuclear Medicine, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338) 
2  Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Leuven, Belgium (GRID:grid.410569.f) 
3  University Hospitals Leuven, Department of Nuclear Medicine, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338); KU Leuven, Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
4  University Hospitals Leuven, Department of Radiology, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338) 
5  University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338) 
6  University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338); KU Leuven, Laboratory of Experimental Radiotherapy, Department of Oncology, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
7  University Hospitals Leuven, Department of Urology, Leuven, Belgium (GRID:grid.410569.f) (ISNI:0000 0004 0626 3338); KU Leuven, Urogenital, Abdominal and Plastic Surgery, Department of Development and Regeneration, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
Publication year
2021
Publication date
Apr 2021
Publisher
Springer Nature B.V.
e-ISSN
2191219X
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13550-021-00783-w
ProQuest document ID
2520050881
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.