Abstract 14548: Coronary and Aortic Calcification Are Common in Men With Recurrent Prostate Cancer Undergoing PET/CT Imaging

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Avira Som ◽  
Preet Ayoub Shaikh ◽  
Daniel Lenihan ◽  
Kathleen W Zhang

Background: Men who receive androgen deprivation therapy for prostate cancer may be at increased risk for cardiovascular events. Vascular calcification is predictive of coronary events in the general population. The prevalence of vascular calcification in men with prostate cancer is not known. Methods: 211 consecutive patients who underwent 18F-fluciclovine positron emission tomography (PET) /computed tomography (CT) at Washington University School of Medicine for recurrent prostate cancer were retrospectively identified. Clinical, demographic, and cardiac biomarker data were obtained from the medical record. Coronary and aortic calcification were qualitatively assessed on non-gated CT scans using standardized scoring systems. Results: Among 211 men with recurrent prostate cancer, median age was 69 (IQR 64, 75) years. Cardiovascular comorbidities were common (70% hypertension, 65% hyperlipidemia, 20% diabetes mellitus, 47% current or former smoking). 21% carried a clinical diagnosis of coronary artery disease while 6% had peripheral vascular disease. On CT imaging, 147 patients (70%) had coronary artery calcification of whom 29 (20%) had severe calcification. Additionally, 189 patients (90%) had aortic calcification on CT imaging of whom 48 (25%) had severe thoracic aortic calcification and 109 (58%) had severe calcification at the aortoiliac bifurcation. Conclusions: Coronary and peripheral vascular calcification are common on PET/CT imaging in men with prostate cancer. Vascular calcification on CT imaging may have utility for cardiovascular risk stratification and guiding implementation of cardiovascular therapies in men receiving androgen deprivation therapy.

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Preet Ayoub Shaikh ◽  
Avira Som ◽  
Daniel Lenihan ◽  
Kathleen W Zhang

Background: Hormone therapy is a front-line therapy for men with prostate cancer and is associated with adverse cardiovascular events. The utility of vascular calcification for cardiovascular risk stratification in men with prostate cancer is unknown. Methods: 211 consecutive patients who underwent 18F-fluciclovine positron emission tomography (PET)/computed tomography (CT) at a single institution for recurrent prostate cancer were retrospectively identified. Clinical and demographic data were obtained from the medical record. Coronary and aortic calcification were qualitatively assessed on non-gated CT scans using standardized scoring systems. The primary outcome was a composite of subsequent major adverse cardiovascular event (MACE; myocardial infarction, stroke, coronary or peripheral revascularization, heart failure hospitalization) or all-cause mortality. Results: Median age was 69 (IQR 64, 75) years and cardiovascular comorbidities were common (70% hypertension, 65% hyperlipidemia, 47% current or former smoking, 20% diabetes mellitus). Over a median of 16.5 months, 8 patients (4%) met the primary outcome. Patients with MACE or death were older and had higher prevalence of traditional cardiovascular comorbidities (risk ratio [RR] 1.3 for hypertension, 1.4 for hyperlipidemia, 1.3 for diabetes mellitus; p>0.05 for all). Coronary and aortic calcification were more common in patients with MACE or death. Severe coronary calcification (RR=6.1, 95% CI 1.6-23.2, p=0.008) and severe thoracic aortic calcification (RR=9.9, 95% CI 2.0-47.6, p=0.004) were associated with significantly increased risk of MACE or death. Conclusions: Coronary and aortic calcification on PET/CT imaging are associated with significantly increased risk of MACE or death in men with recurrent prostate cancer. Vascular calcification may have utility for cardiovascular risk stratification in men receiving hormone therapy for prostate cancer.


2018 ◽  
Vol 14 (11) ◽  
pp. 1101-1115 ◽  
Author(s):  
Lucia Zanoni ◽  
Irene Bossert ◽  
Antonella Matti ◽  
Riccardo Schiavina ◽  
Cristian Pultrone ◽  
...  

2019 ◽  
Vol 61 (6) ◽  
pp. 881-889 ◽  
Author(s):  
Esther Mena ◽  
Maria Liza Lindenberg ◽  
Ismail Baris Turkbey ◽  
Joanna H. Shih ◽  
Stephanie A. Harmon ◽  
...  

Biomedicines ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 511
Author(s):  
Joachim Brumberg ◽  
Melanie Beckl ◽  
Alexander Dierks ◽  
Andreas Schirbel ◽  
Markus Krebs ◽  
...  

Prostate-specific membrane antigen (PSMA) ligand PET/CT enables the localization of tumor lesions in patients with recurrent prostate cancer, but it is unclear whether androgen deprivation therapy (ADT) influences diagnostic accuracy. The aim of this study was to evaluate the effect of ADT on the detection rate of 68Ga-PSMA ligand PET/CT. Thus, 399 patients with initial radical prostatectomy and 68Ga-PSMA ligand PET/CT during PSA relapse were retrospectively evaluated. Propensity score matching was used to create two balanced groups of 62 subjects who either did or did not receive ADT within six months before imaging. All 68Ga-PSMA ligand PET/CT were evaluated visually and with semiquantitative measures. The detection rate of tumor recurrence was significantly higher in the group with ADT (88.7% vs. 72.6%, p = 0.02) and improved with increasing PSA-levels in both groups. In subjects with pathological PET/CT and ADT, whole-body total lesion PSMA (p < 0.01) and PSMA-derived tumor volume (p < 0.01) were significantly higher than in those without ADT. More PSMA-positive lesions and higher PSMA-derived volumetric parameters in patients with ADT suggest that a better detection rate is related to a (biologically) more advanced disease stage. Due to high detection rates in patients with PSA-levels < 2 ng/mL, the withdrawal of ADT before PSMA ligand PET/CT cannot be recommended.


2017 ◽  
Vol 45 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Esther Mena ◽  
Maria L. Lindenberg ◽  
Joanna H. Shih ◽  
Stephen Adler ◽  
Stephanie Harmon ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document