scholarly journals Competition (‘Steal’ Phenomenon) betwe en [68Ga]Ga-PSMA-11 Uptake in Prostate Tumor Tissue Versus Healthy Tissue

Pharmaceutics ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 699
Author(s):  
Esmée C. A. van der van der Sar ◽  
Bart de de Keizer ◽  
Marnix G. E. H. Lam ◽  
Arthur J. A. T. Braat
Keyword(s):  
Prostate Cancer ◽  
Tumor Tissue ◽  
Prostate Tumor ◽  
Healthy Tissue ◽  
P Value ◽  
Parotid Glands ◽  
Steal Phenomenon ◽  
Pet Ct ◽  
Quantitative Image ◽  
Specific Membrane

We aimed to clarify whether a steal ‘phenomenon’ exists by investigating if uptake of ‘prostate specific membrane antigen’ (PSMA) in prostate tumor tissue correlates with the uptake in healthy tissue. Patients with prostate cancer referred for a [68Ga]Ga-PSMA-11 PET/CT were identified retrospectively. Semi-automated quantitative image analysis was performed; fractional healthy tissue [68Ga]Ga-PSMA-11 uptake volume (HT-PSMA (SUV*cm3)) in the lacrimal, submandibular, and parotid glands, and kidneys, and the fractional total lesion [68Ga]Ga-PSMA-11 uptake volume (TL-PSMA (SUV*cm3)) of prostate cancer were used. Ninety-two patients, age 78 ± 8 years, were analyzed. Median TL-PSMA was 703.37 SUV*cm3 (IQR 119.56–2778.20), median HT-PSMA of the lacrimal, submandibular, and parotid glands, and kidneys was: 13.69 (IQR 7.29–19.06), 194.75 (IQR 133.67–276.53), 552.54 (IQR 379.98–737.16), and 8092.75 SUV*cm3 (IQR 5793.02–11385.86), respectively. A significant (p-value ≤ 0.001) but weak–moderate correlation was found between the TL-PSMA and HT-PSMA of the parotid- and submandibular glands, and kidneys (correlation coefficient of −0.447,−0.345, and −0.394, respectively). No correlation was found between TL-PSMA and HT-PSMA of the lacrimal glands. The existence of a ‘steal’ phenomenon cannot be confirmed in this study. Healthy tissue uptake of [68Ga]Ga-PSMA-11 is only partially influenced by TL-PSMA. Thus, modification of therapeutic PSMA activity should not be adjusted based on TL-PSMA alone.

Head-to-Head Comparison of 18F-Prostate-Specific Membrane Antigen-1007 and 18F-Fluorocholine PET/CT in Biochemically Relapsed Prostate Cancer

2019 ◽  
Vol 44 (12) ◽  
pp. e629-e633 ◽  
Author(s):  
Ewa Witkowska-Patena ◽  
Agnieszka Giżewska ◽  
Mirosław Dziuk ◽  
Jolanta Miśko ◽  
Anna Budzyńska ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Membrane Antigen ◽  
Pet Ct ◽  
Specific Membrane

A Comprehensive Safety Evaluation of 68Ga-Labeled Ligand Prostate-Specific Membrane Antigen 11 PET/CT in Prostate Cancer

2017 ◽  
Vol 42 (7) ◽  
pp. 520-524 ◽  
Author(s):  
Julie B. Nielsen ◽  
Helle D. Zacho ◽  
Uwe Haberkorn ◽  
Karin M. Nielsen ◽  
Katja Dettmann ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Safety Evaluation ◽  
Prostate Specific Membrane Antigen ◽  
Pet Ct ◽  
Specific Membrane

Evaluation of early clinical experience of a novel prognostic proteomics prostate cancer biopsy test.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 88-88 ◽  
Author(s):  
Sibgat Choudhury ◽  
Bruce J. Trock ◽  
Rene Benson Skone ◽  
Julie Nardone ◽  
James Dunyak ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Score ◽  
Validation Study ◽  
Prostate Tumor ◽  
Risk Scores ◽  
P Value ◽  
Score Distribution ◽  
Aggressive Disease ◽  
Tumor Pathology ◽  
Intended Use

88 Background: Standard clinical and pathological parameters derived from diagnostic biopsy are insufficient to accurately assess final prostate tumor pathology of patients with biopsy Gleason grades 3+3 or 3+4. We developed a novel assay (ProMark) that performs quantitative measurements of 8 protein markers from prostate biopsy FFPE sections. In the validation study, assay risk scores were strongly predictive of final prostate tumor pathology with a C-stat of 0.69 (95%CI = 0.63 – 0.76) (p<0.0001). By design, the train-test (N=381) and validation (N=274) studies were enrichment studies, with a higher % of aggressive disease than in the intended use population. Here we study 293 needle biopsy cases that have come to our CLIA lab for ProMark testing over a four month period. The objective of this study is to establish the ProMark score distribution for these ‘real world’ clinical use patients, and to confirm that this distribution matches our clinical validation study. Methods: To establish prevalence of aggressive disease in the intended use population, we used the Institutional Urology Prostate Cancer Database at Johns Hopkins. Among 9,305 men with biopsy Gleason 3+3 or 3+4 and prostatectomy from 2004-2014 the distribution of favorable (GS<4+3 & organ confined) and unfavorable (GS≥4+3 or non-organ confined) based on surgical pathology is 73.1% vs. 26.9%. The adjusted risk score distribution from the validation trial (N=274) is then compared to the CLIA lab samples (N=293), based on cumulative distributions and binomial confidence intervals. Results: Comparison of the risk score distribution of early clinical data with the population-adjusted validation score distribution shows good agreement based on 95% CIs. Table shows expected and measured frequencies in Low, Intermediate and High risk categories. The K-S test for comparison of distributions has p-value=0.44, supporting equivalence of distribution. Conclusions: The results of our study show that early clinical practice closely matches expectations from controlled clinical studies. [Table: see text]

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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