scholarly journals Non-Prostate Cancer Tumours: Incidence on 18f-Dcfpyl Psma Pet/Ct and Psma Expression Characteristics in 1445 Patients.

2021 ◽  
Author(s):  
Elisa Perry ◽  
Arpit Talwar ◽  
Sanjana Sharma ◽  
Daisy O'Connor ◽  
Lih-Ming Wong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Second Primary ◽  
Public And Private ◽  
Histopathological Correlation ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Second Primary Malignancies ◽  
Clinical Dilemma ◽  
Psma Expression

Abstract PurposeProstate cancer (PCa) imaging has been revolutionized by Positron emission tomography (PET) tracers targeted to prostate specific membrane antigen (PSMA). Identification and characterization of non-PCa tumors has become an increasing clinical dilemma with growing use. The primary aim of this retrospective multicenter analysis was to determine atypical PSMA expression in PCa and expression in non-PCa tumors to aid providing clinically relevant reports and guiding multidisciplinary discussion.MethodsRetrospective multicenter study examining 1445 consecutive 18F-DCFPyL PSMA PET/CT between 2016-2020. Referrals were from public and private, secondary and tertiary referral centres serving New Zealand and Melbourne. Repeat studies were excluded. Lesions atypical for PCa were categorized into four groups: 1. Atypical PCa metastases 2. Non-PCa tumors 3. Benign and 4. Indeterminate.Results67 patients had lesions atypical for PCa metastases; 11.9% atypical prostate cancer metastases, 25.4% non-PCa tumors, 40.3% indeterminate, 10.4% benign. With the exception of Renal Cell Carcinoma (RCC), the non-PCa tumors, indeterminate and benign lesions demonstrated low PSMA expression. Most atypical PCa metastases demonstrated significant expression. Limitations included retrospective design and lack of histopathological correlation/follow up in some.Conclusions: Non-PCa tumor detection is low. Lesions demonstrating significant PSMA expression were almost exclusively PCa metastases. Differentiation of atypical PCa metastases from second primary malignancies is vital to avoid unnecessary investigation, delayed therapy and additional costs.

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.

Characterization of PSMA and 18F-fluciclovine transporter gene expression in localized prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 295-295
Author(s):  
Carissa Chu ◽  
Mohammed Alshalalfa ◽  
Martin Sjöström ◽  
Shuang Zhao ◽  
Annika Herlemann ◽  
...  
Keyword(s):  
Gene Expression ◽  
Prostate Cancer ◽  
Clinical Outcomes ◽  
Molecular Subtypes ◽  
Localized Prostate Cancer ◽  
Transporter Gene ◽  
Psma Pet ◽  
Pet Ct ◽  
Genomic Risk ◽  
Psma Expression

295 Background: While 18F-fluciclovine PET/CT is approved in the US and recommended by the NCCN, prostate-specific membrane antigen (PSMA) PET/CT is more common in Europe/Australia and recommended by the EAU. Less is known about the biology of lesions detected by either modality. 18F-fluciclovine PET relies on radiotracer uptake by amino acid transporters LAT1-4 and ASCT1-2. PSMA PET is dependent on surface expression of PSMA. We compared relative expression of PSMA and fluciclovine transporter genes in radical prostatectomy (RP) samples to determine their distribution across subtypes and correlation with outcomes. Methods: Gene expression data of 19,102 RP samples were analyzed using the Affymetrix Human Exon 1.0 ST microarray. 1,135 patients had long term follow up. Associations between expression of PSMA and fluciclovine transporter genes (LAT1-4 and ASCT1-2) and pathologic variables, molecular subtypes, and clinical outcomes were conducted. Results: All fluciclovine transporter genes (LAT 1-4, ASCT1-2) were expressed at lower levels than PSMA (p <0.0001). PSMA expression was positively correlated with genomic risk score and pathologic Gleason score (p<0.0001), but LAT2-3 and ASCT2 were inversely correlated with genomic risk in primary tumors (p<0.0001) and less expressed in GS 9-10 tumors (p<0.0001). PSMA expression was associated with worse metastasis-free survival (MFS) (HR 1.45, p=0.001) and lymph node involvement (HR 2.14, p<0.0001). Expression of LAT2, LAT3, ASCT2 expression was associated with better MFS (HR 0.85, 0.63, 0.74, p<0.0001-0.04). After multivariable adjustment, PSMA expression remained independently prognostic of poorer MFS (HR 1.3, p=0.028). Luminal B subtype was notable for PSMA overexpression; Luminal A was enriched in ASCT2 and LAT2 (p<0.0001). PSMA expression did not correlate with ERG fusion prostate cancers, but LAT2, ASCT1, and ASCT2 were overexpressed in ERG fusion negative tumors (p<0.0001). Conclusions: PSMA expression is associated with more aggressive disease and poorer clinical outcomes than fluciclovine transporter genes in localized prostate cancer. Molecular subtypes of prostate cancer vary in PSMA and fluciclovine transporter gene expression.

scholarly journals Immunohistochemical Validation of PSMA Expression Measured by 68Ga-PSMA PET/CT in Primary Prostate Cancer

2017 ◽  
Vol 59 (2) ◽  
pp. 238-243 ◽  
Author(s):  
Nadine Woythal ◽  
Ruza Arsenic ◽  
Carsten Kempkensteffen ◽  
Kurt Miller ◽  
Jan-Carlo Janssen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Primary Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Psma Expression

scholarly journals Machine learning for differentiating metastatic and completely responded sclerotic bone lesion in prostate cancer: a retrospective radiomics study

2019 ◽  
Vol 92 (1101) ◽  
pp. 20190286 ◽  
Author(s):  
Emine Acar ◽  
Asım Leblebici ◽  
Berat Ender Ellidokuz ◽  
Yasemin Başbınar ◽  
Gamze Çapa Kaya
Keyword(s):  
Prostate Cancer ◽  
Machine Learning ◽  
Texture Analysis ◽  
Area Under The Curve ◽  
Ct Images ◽  
Metastatic Lesions ◽  
Psma Pet ◽  
Pet Ct ◽  
Sclerotic Lesions ◽  
Psma Expression

Objective:Using CT texture analysis and machine learning methods, this study aims to distinguish the lesions imaged via 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/CT as metastatic and completely responded in patients with known bone metastasis and who were previously treated.Methods:We retrospectively reviewed the 68Ga-PSMA PET/CT images of 75 patients after treatment, who were previously diagnosed with prostate cancer and had known bone metastasis. A texture analysis was performed on the metastatic lesions showing PSMA expression and completely responded sclerotic lesions without PSMA expression through CT images. Textural features were compared in two groups. Thus, the distinction of metastasis/completely responded lesions and the most effective parameters in this issue were determined by using various methods [decision tree, discriminant analysis, support vector machine (SVM), k-nearest neighbor (KNN), ensemble classifier] in machine learning.Results:In 28 of the 35 texture analysis findings, there was a statistically significant difference between the two groups. The Weighted KNN method had the highest accuracy and area under the curve, has been chosen as the best model. The weighted KNN algorithm was succeeded to differentiate sclerotic lesion from metastasis or completely responded lesions with 0.76 area under the curve. GLZLM_SZHGE and histogram-based kurtosis were found to be the most important parameters in differentiating metastatic and completely responded sclerotic lesions.Conclusions:Metastatic lesions and completely responded sclerosis areas in CT images, as determined by 68Ga-PSMA PET, could be distinguished with good accuracy using texture analysis and machine learning (Weighted KNN algorithm) in prostate cancer.Advances in knowledge:Our findings suggest that, with the use of newly emerging software, CT imaging can contribute to identifying the metastatic lesions in prostate cancer.

Differential expression of PSMA and 18F-fluciclovine transporter genes in metastatic castrate-resistant and treatment-emergent small cell/neuroendocrine prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 24-24
Author(s):  
Carissa Chu ◽  
Mohammed Alshalalfa ◽  
Martin Sjöström ◽  
Shuang Zhao ◽  
Annika Herlemann ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Expression Profiles ◽  
Small Cell ◽  
Imaging Modalities ◽  
Primary Tumors ◽  
Neuroendocrine Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Castrate Resistant ◽  
Psma Expression

24 Background: 18F-fluciclovine (Axumin) PET/CT imaging is recommended by the NCCN in the setting of biochemical recurrence, while prostate-specific membrane antigen (PSMA) PET/CT is preferred by the EAU. The utility of these methods in the post-androgen deprivation therapy (ADT) setting however, is less defined. Our objective was to compare relative gene expression of the molecular targets of these imaging modalities— fluciclovine transporter genes (LAT1-4, ASCT1-2) and PSMA—in metastatic castrate resistant prostate cancer (mCRPC) and treatment-emergent small cell/neuroendocrine prostate cancer (t-SCNC). Methods: Genome-wide expression profiles of five mCRPC cohorts (Aggarwal, Grasso, Kumar, Beltran, Robinson, et al) were used to characterize relative expression of fluciclovine transporter (LAT1-4, ASC1-2) and PSMA (FOLH1) genes. 3 cohorts (Kumar, Beltran, Aggarwal) were enriched with t-SCNC tumors. The GSE35988 cohort included primary tumors and mCRPC. RNA expression profiling methods were consistent within cohorts. Results: 518 mCRPC specimens were included. In the GSE35988 cohort, PSMA expression was downregulated in mCRPC when compared to primary localized tumors (p=0.01). PSMA expression was further depressed in t-SCNC when compared with mCRPC (p<0.001). Of the fluciclovine transporter genes, LAT1 and LAT4 were overexpressed in mCRPC when compared to primary tumors, while ASC2 was less expressed (p<0.001). LAT1 was further overexpressed in t-SCNC when compared to mCRPC, while LAT2 was less expressed (p<0.001). PSMA expression was negatively correlated with LAT1 (p<0.001) but positively correlated with LAT2 (p=0.006). Other fluciclovine transporters were not correlated. Conclusions: Expression of PSMA and a subset of fluciclovine transporter genes are inversely correlated in mCRPC and t-SCNC. These findings suggest that fluciclovine-based imaging may play a role in castrate resistant states. Clinical comparison between PSMA- and fluciclovine-based imaging modalities in mCRPC and t-SCNC is warranted.

scholarly journals Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

2020 ◽  
Vol 9 (5) ◽  
pp. 1390
Author(s):  
Philipp E. Hartrampf ◽  
Marieke Heinrich ◽  
Anna Katharina Seitz ◽  
Joachim Brumberg ◽  
Ioannis Sokolakis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Therapy Response ◽  
Tumour Volume ◽  
Ct Scans ◽  
Metabolic Tumour Volume ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Before And After ◽  
Statistical Comparability

(1) Background: Prostate-specific membrane antigen (PSMA)-derived tumour volume (PSMA-TV) and total lesion PSMA (TL-PSMA) from PSMA PET/CT scans are promising biomarkers for assessing treatment response in prostate cancer (PCa). Currently, it is unclear whether different software tools for assessing PSMA-TV and TL-PSMA produce comparable results. (2) Methods: 68Ga-PSMA PET/CT scans from n = 21 patients with castration-resistant PCa (CRPC) receiving chemotherapy were identified from our single-centre database. PSMA-TV and TL-PSMA were calculated with Syngo.via (Siemens) as well as the freely available Beth Israel plugin for FIJI (Fiji Is Just ImageJ) before and after chemotherapy. While statistical comparability was illustrated and quantified via Bland-Altman diagrams, the clinical agreement was estimated by matching PSMA-TV, TL-PSMA and relative changes of both variables during chemotherapy with changes in serum PSA (ΔPSA) and PERCIST (Positron Emission Response Criteria in Solid Tumors). (3) Results: Comparing absolute PSMA-TV and TL-PSMA as well as Bland–Altman plotting revealed a good statistical comparability of both software algorithms. For clinical agreement, classifying therapy response did not differ between PSMA-TV and TL-PSMA for both software solutions and showed highly positive correlations with BR. (4) Conclusions: due to the high levels of statistical and clinical agreement in our CRPC patient cohort undergoing taxane chemotherapy, comparing PSMA-TV and TL-PSMA determined by Syngo.via and FIJI appears feasible.

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