PSMA-PET/CT-avid metastatic prostate cancer to the penis

2020 ◽  
Vol 13 (3) ◽  
pp. e233522
Author(s):  
Margaret Mary Mansbridge ◽  
Andrew Strahan ◽  
Jonathon Parker ◽  
Handoo Rhee
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Penile Metastasis ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Malignant Priapism ◽  
Specific Membrane ◽  
Penile Metastases

Penile metastases from prostate cancer (PC) are rarely reported in the literature. Most commonly diagnosed due to presentation with malignant priapism and other urinary symptoms or from findings on clinical examination, prognosis has been reported to be poor. The authors outline a case of penile metastasis from advanced PC. Initially treated with neoadjuvant androgen deprivation therapy for locally advanced PC, this patient displayed upfront castrate resistance, and subsequent prostate-specific membrane antigen positron emission tomography revealed penile metastatic deposits. The patient was treated with external beam radiotherapy, and worsening urethral stricture disease resulted in the placement of a suprapubic catheter.

scholarly journals Combined Intravenous Urogram and 68Ga-PSMA PET/ CT for Improved Staging and Restaging of Prostate Cancer

2020 ◽  
Vol 10 ◽  
pp. 67
Author(s):  
Rhiannon McBean ◽  
Anisa Kumari ◽  
Louise McEwan ◽  
James Walters ◽  
David Wong
Keyword(s):  
Prostate Cancer ◽  
Imaging Protocol ◽  
Intravenous Urogram ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Imaging Approach ◽  
Pictorial Essay ◽  
Gallium 68 ◽  
Specific Membrane

Staging/restaging of prostate cancer utilizing Gallium-68 (68Ga) prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in combination with an intravenous urogram allows improved discrimination between radiotracer activity in the renal tract and small pelvic nodes or local recurrences. Within this pictorial essay, we describe the imaging protocol utilized at our institution and present cases which demonstrate the utility of this combined imaging approach.

scholarly journals Evaluation of 18F-DCFPyL PSMA PET/CT for Prostate Cancer: A Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Ke-Hao Pan ◽  
Jin-Feng Wang ◽  
Chun-Ying Wang ◽  
Abdul Aziz Nikzad ◽  
Fang Q. Kong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Ct Diagnosis ◽  
Clinical Value ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Specific Membrane

BackgroundTo systematically review the clinical value of 18F-DCFPyL prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in the diagnosis of prostate cancer (PCa).MethodsLiterature concerning 18F-DCFPyL PSMA PET/CT in the diagnosis of prostate cancer published from 2015 to 2020 was electronically searched in the databases including PubMed and Embase. Statistical analysis was carried out with STATA 15 software, and the quality of included studies was tested with quality assessment of diagnostic accuracy studies (QUADAS) items. The heterogeneity of the included data was tested.ResultsIn total, nine pieces of literature involving 426 patients met the inclusion criteria. The heterogeneity of the study group was not obvious. The SEN, SPE, LR+, LR−, DOR as well as AUC of 18F-DCFPyL PSMA PET/CT diagnosis of prostate cancer were 0.91, 0.90, 8.9, 0.10, 93, and 0.93. The pooled DR of 18F-DCFPyL labeled PSMA PET/CT in PCa was 92%. The pooled DR was 89% for PSA≥0.5 ng/ml and 49% for PSA < 0.5ng/ml.Conclusion18F-DCFPyL PSMA PET/CT had good sensitivity and specificity for the diagnosis of prostate cancer. The DR of 18F-DCFPyL PSMA PET/CT was correlated with PSA value. Further large-sample, high-quality studies were needed.

scholarly journals PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Froehner ◽  
Marieta Toma ◽  
Klaus Zöphel ◽  
Vladimir Novotny ◽  
Michael Laniado ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Biopsy ◽  
Bone Lesion ◽  
Emission Tomography ◽  
Newly Diagnosed ◽  
Paget Disease ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Specific Membrane

A 67-year-old man diagnosed with Gleason score4+5=9clinically localized prostate cancer with68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

scholarly journals Case Report: 18F-PSMA PET/CT May Improve the Clinical Management of Penile Metastases From Prostate Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Junjie Fan ◽  
Hua Liang ◽  
Xing Zhang ◽  
Xingfa Chen ◽  
Xiaoyi Duan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Diagnosis ◽  
Early Stage ◽  
Case Reports ◽  
Survival Advantage ◽  
Pathological Feature ◽  
Penile Metastasis ◽  
Psma Pet ◽  
Pet Ct ◽  
Penile Metastases

Metastases from prostate cancer (PCa) to the penis are extremely rare, and few case reports exist in the literature. Because most patients usually present with multiple distant metastases at diagnosis, the prognosis is very poor. With the wide application of prostate-specific membrane antigen (PSMA) PET/CT, penile metastases may be detected at an early stage. Thus, questions regarding whether early diagnosis and precise treatment will equate to a survival advantage have recently been raised. In the present study, we reported 3 cases of penile metastasis from castration-resistant PCa. Moreover, a patient with asymptomatic penile metastases was diagnosed by 18F-PSMA PET/CT followed by lesion biopsy, and the prognosis was very well, despite with an aggressive pathological feature and low treatment intensity. In addition, we performed a literature review and found 62.5% of asymptomatic penile metastases were diagnosed by PSMA PET/CT in past seven years. Thus, we believe that PSMA PET/CT may detect more asymptomatic penile metastases in future, which led to early diagnosis, treatment and survival advantage.

scholarly journals Can 68Ga-prostate specific membrane antigen positron emission tomography/computerized tomography provide an accurate lymph node staging for patients with medium/high risk prostate cancer? A diagnostic meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lei Peng ◽  
Jinze Li ◽  
Chunyang Meng ◽  
Jinming Li ◽  
Chengyu You ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Positron Emission Tomography ◽  
Lymph Node ◽  
High Risk ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Emission Tomography ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct

Abstract Objective This article aims to evaluate the diagnostic value of 68Gallium-PSMA positron emission tomography/computerized tomography (68Ga-PSMA PET/CT) for lymph node (LN) staging in patients with prostate cancer (PCa) by a meta-analysis of diagnostic tests. Methods We systematically retrieved articles from Web of Science, EMBASE, Cochrane Database, PubMed. The time limit is from the creation of the database until June 2019, and Stata 15 was used for calculation and statistical analyses. Results Sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR) and 95% confidence intervals (CI) be used to evaluate the diagnostic value. A total of 10 studies were included in our meta-analysis, which included 701 individuals. The results of each consolidated summary are as follows: sensitivity of 0.84 (95% CI 0.55–0.95), specificity of 0.95 (95% CI 0.87–0.98), PLR and NLR was 17.19 (95% CI 6.27, 47.17) and 0.17 (95% CI 0.05–0.56), respectively. DOR of 100 (95% CI 18–545), AUC of 0.97 (95% CI 0.95–0.98). Conclusion Our study demonstrates that 68Ga-PSMA PET/CT has a high overall diagnostic value for LN staging in patients with moderate and high-risk PCa. But our conclusions still require a larger sample size, multi-center prospective randomized controlled trial to verify.

scholarly journals Comparison of 68Ga-PSMA-11 PET/CT with 11C-acetate PET/CT in re-staging of prostate cancer relapse

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Naresh Regula ◽  
Vasileios Kostaras ◽  
Silvia Johansson ◽  
Carlos Trampal ◽  
Elin Lindström ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Anatomical Location ◽  
Curative Therapy ◽  
Psa Relapse ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Prostate Cancer Relapse ◽  
Identical Number

AbstractPositron emission tomography (PET) imaging is used to localize recurrent disease in prostate cancer (PCa). The tracer 68Ga-PSMA-11 visualizes lesions overexpressing prostate-specific membrane antigen (PSMA), while 11C-acetate visualizes lesions with increased anabolic metabolism. The aim of this study was to compare the performance of PSMA-PET and acetate-PET in re-staging patients with biochemical relapse. Thirty PCa patients with prostate-specific antigen (PSA) relapse after primary curative therapy were prospectively evaluated. PET/CT examinations using 11C-acetate and 68Ga-PSMA-11 were performed. Identified lesions were categorized according to anatomical location and PET measurements were correlated with PSA at time of scan. Tumour lesions showed higher semi-quantitative uptake values on PSMA-PET than acetate-PET. PSMA-PET identified more lesions in 11 patients, fewer lesions in eight patients, and identical number of lesions in 11 patients. This study indicates better diagnostic performance of PSMA-PET, particularly in detecting lymph node (81% vs 60%, p = 0.02) and bone metastasis (95% vs 61%, p = 0.0001) compared to acetate-PET. However, 38% of PSMA-expressing metastases appear to be metabolically inactive and 15% of metabolically active metastases lack PSMA expression. Addition of PET with a metabolic tracer, such as 11C-acetate, might be beneficial before making treatment decisions.

Prediction of postoperative histology in patients with prostate cancer using preoperative Ga-68-PSMA-PET/CT.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 144-144
Author(s):  
Martin Boegemann ◽  
Axel Semjonow ◽  
Hans-Joerg Breyholz ◽  
Andres Jan Schrader ◽  
Laura-Maria Krabbe ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Standard Uptake Value ◽  
Whole Body ◽  
Diagnostic Tools ◽  
Likelihood Ratios ◽  
Psma Pet ◽  
Pet Ct ◽  
Detect Prostate Cancer ◽  
Sensitivity Specificity ◽  
Specific Membrane

144 Background: Recently developed 68Ga labeled prostate specific membrane antigen (PSMA) ligands were introduced as diagnostic tools to detect prostate cancer (PCa), PCa relapse and metastases with high accuracy. In this study we assessed the usability of preoperative PSMA-PET/CT information on congruency of spread of PCA compared with postoperative PCa-maps derived from radical prostatectomy (RPE) specimens. Methods: We referred 6 patients with biopsy proven high risk PCa to PSMA-PET/CT prior to RPE. Whole body PET/CT (Biograph mCT with 128 slice CT, Siemens) was performed 62±8 minutes after injection of 160±31 MBq [68Ga]-PSMA-HBED-CC (DKFZ-Ga-PSMA-11) as described by routine acquisition protocol. After RPE, prostate specimens were processed in the local pathology department. Topographical analysis of extension of PCa was reconstructed from representative slides on a schematic diagram resulting in a PCa-map of the prostate. After aligning the cutting planes of the PSMA-PET/CT to the PCa-map we defined 20 segments of the prostate and the seminal vesicles. We measured the maximum standard uptake value (SUV) of PSMA activity of the respective segments and compared the concordance of PSMA-positive and -negative areas with those of PCa and no PCa on the PCa-maps. We calculated sensitivity, specificity, positive and negative likelihood ratios (LR) taking available segments into account. Results: 106/112 segments were analyzed. 8 segments were excluded due to spillover of PSMA-activity in bladder urine. All but 3 segments with no PCa on the PCa-maps showed no uptake in PSMA-PET/CT (Specificity = 92%). The sensitivity of PSMA-PET/CT for showing PCa areas was equally 92%. The positive and negative LR for PSMA-PET/CT detecting or ruling out PCa was 11.5 and 0.09, respectively. Conclusions: This preliminary proof of concept study shows that prediction of later pathologic results in RPE-specimens could be estimated by preoperative PSMA-PET/CT. With optimized acquisition protocols it may be possible to improve our preliminary results. Perspectively PSMA-PET/CT may be helpful for identifying PCa suspicious lesions prior to prostate biopsy and support decision making prior to RPE or radiation therapy.

Prostate-specific membrane antigen (PSMA) PET-CT guided radiotherapy in oligometastatic prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 213-213
Author(s):  
Benedikt Engels ◽  
Ozan Cem Guler ◽  
Cem Onal ◽  
Mark De Ridder
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Pelvic Bone ◽  
Prostate Specific Membrane Antigen ◽  
Ct Guided ◽  
Castration Resistant ◽  
Psma Pet ◽  
Pet Ct ◽  
Oligometastatic Prostate Cancer ◽  
Specific Membrane

213 Background: Metastases-directed therapy by metastasectomy or radiotherapy (RT) might delay disease progression and postpone systemic treatment in patients with oligometastatic prostate cancer. Here, we evaluated retrospectively the efficacy and toxicity of 68Ga prostate-specific membrane antigen (PSMA) PET-CT guided radiotherapy (RT) in the treatment of oligometastatic prostate cancer. Methods: A total of 23 prostate cancer patients with biochemical relapse, of which 13 castration-sensitive and 10 castration-resistant, were treated with intensity-modulated and image-guided RT (IMRT-IGRT) on ≤ 3 metastases detected by 68Ga PSMA PET-CT. Androgen deprivation therapy was continued in castration-resistant patients. Local control (LC), progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Results: A total of 38 metastases were treated. Involved sites were pelvic bone (n = 16), pelvic lymph nodes (n = 11), para-aortic lymph nodes (n = 6), ribs (n = 3) and vertebral body (n = 2). The median PSA prior to RT was 1.06 ng/ml (range 0.10 – 29.0 ng/ml). A median dose of 43.5 Gy (range, 30-64 Gy) was delivered by IMRT-IGRT in 12-27 fractions. At a median follow-up of 7 months (range, 2-17 months), 19 patients (83%) are in remission. Four patients (17%) developed distant recurrence. The actuarial 1-year LC, PFS and OS rates were 100%, 51% (95% CI 8-83%) and 100%. Castration-sensitive patients displayed a statistically significantly superior PFS on univariate analysis as compared to castration-resistant patients (1-year PFS 67% vs 0%, p < 0.01). One patient experienced grade 2 acute gastro-intestinal toxicity. No grade 3 or more toxic events were observed. Conclusions: By providing optimal LC, low toxicity and a promising PFS in castration-sensitive patients, the current retrospective study illustrated that 68Ga PSMA PET-CT guided RT may be an attractive treatment option in patients with oligometastatic prostate cancer. Validation by randomized trials is eagerly awaited.

scholarly journals 18F-PSMA-1007 PET in Biochemical Recurrent Prostate Cancer: An Updated Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Matteo Ferrari ◽  
Giorgio Treglia
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Emission Tomography ◽  
Prostate Specific Membrane Antigen ◽  
Targeted Agents ◽  
Recurrent Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
Specific Membrane

Background. Prostate-specific membrane antigen- (PSMA-) targeted agents labeled with fluorine-18 (18F) have recently become available to evaluate patients with biochemical recurrent prostate cancer (BRPCa) by using positron emission tomography/computed tomography (PET/CT) or positron emission tomography/magnetic resonance imaging (PET/MRI). We performed a systematic review and meta-analysis about the detection rate (DR) of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa patients. Methods. A comprehensive computer literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases for studies published through 17 May 2021 was carried out using the following search algorithm: “PSMA” AND “1007”. Only studies providing data on the DR of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa were included. A random-effects model was used to calculate the pooled DR on a per scan basis. Results. Fifteen articles (853 patients) were selected and included in the systematic review, and ten were included in the quantitative analysis. Most of the studies reported a good DR of 18F-PSMA-1007 PET/CT or PET/MRI in BRPCa including also patients with low prostate-specific membrane antigen (PSA) values. The DR of 18F-PSMA-1007 PET/CT or PET/MRI was dependent on PSA serum values. The pooled DR was 81.3% (95% confidence interval: 74.6–88%) with statistical heterogeneity. A significant reporting bias (publication bias) was not detected. Conclusions. 18F-PSMA-1007 PET/CT or PET/MRI showed a good DR in BRPCa patients in line with other PSMA-targeted agents. The DR of 18F-PSMA-1007 PET/CT or PET/MRI is influenced by serum PSA values. These findings should be confirmed by prospective multicentric trials.

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