scholarly journals The Role of PET/CT with 68Ga‑PSMA in the Primary Diagnosis of Prostate Cancer

2021 ◽  
Vol 4 (4) ◽  
pp. 20-27
Author(s):  
A. L. Dolbov ◽  
A. A. Stanjevskiy ◽  
D. N. Maistrenko ◽  
M. I. Shkolnik ◽  
А. Yu. Pakhomov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Lymph Nodes ◽  
Bone Scan ◽  
Specific Antigen ◽  
Malignant Neoplasms ◽  
Optimal Method ◽  
Regional Lymph Nodes ◽  
Pet Ct ◽  
The Impact

Relevance: Prostate cancer is one of the most frequently diagnosed malignant neoplasms of the genitourinary system in men in the world. Recently, there has been an active introduction into clinical practice of positron emission tomography technology combined with computed tomography (PET/CT) with 68Ga‑PSMA‑617 based on prostate‑specific membrane antigen (PSMA), the capabilities of which significantly increase the effectiveness of the diagnosis of prostate cancer at various clinical stages compared with routine methods used in the staging of prostate cancer.Purpose: To compare the diagnostic effectiveness of PET/CT with 68Ga‑PSMA‑617 with traditional methods of radiation imaging (computed tomography, magnetic resonance imaging and bone scan) in the staging of prostate cancer and to clarify the impact of this technology on the choice of surgical treatment.Material and methods: PET/CT with 68Ga‑PSMA was performed in our center in order to stage the verified prostate cancer in 109 patients aged 48 to 80 years (median 64.5). The selection criteria were: a PSA level of more than 5 ng/ml, the presence of a newly identified, histologically verified prostate cancer, lack of treatment, suspicion of metastatic lesion of the lymph nodes of the pelvis and skeleton. Patients were divided into groups by prostate‑specific antigen level, Gleason score, and d’Amico.Results: In the analysis of PET/CT results and MRI/CT comparison and Bone scan, 56 (51.4 %) of 109 patients showed a change in the TNM stage. A change in the data on the local spread of the tumor with an increase in the stage according to criterion T due to the detection of pathological accumulation of RFP in seminal vesicles was detected in 21 (37.5 %) of 56 patients. Additionally, according to PET/CT data, 13 (23.2 %) of 56 patients were found to have lesions of regional lymph nodes (N). Metastatic lesions of distant lymph nodes (M1a) and bones (M1b), not visualized during routine radiation examination, were observed in 32 (57.1 %) and 36 (64.3 %) of 56 patients, respectively.Conclusions: The use of PET/CT 68Ga‑PSMA‑617 in patients with newly diagnosed prostate cancer at the staging stage allows us to obtain valuable additional information about the local, regional and long‑term prevalence of the pathological process, and in some cases — to change the stage of the disease by TNM (usually by increasing it), which has a significant impact on the tactics of therapeutic measures and the choice of the optimal method of therapy for prostate cancer.

scholarly journals Role of Androgen Deprivation Therapy for Node-Positive Prostate Cancer

2009 ◽  
Vol 27 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Yu-Ning Wong ◽  
Stephen Freedland ◽  
Brian Egleston ◽  
Gary Hudes ◽  
J. Sanford Schwartz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Regional Lymph Nodes ◽  
Node Positive ◽  
Survival Difference ◽  
Significant Difference ◽  
The Impact

Purpose To determine the impact of adjuvant androgen deprivation therapy (ADT) for patients who have node-positive prostate cancer in the prostate-specific antigen (PSA) era. Patients and Methods We used linked Surveillance, Epidemiology and End Results-Medicare data to construct a cohort of men who underwent radical prostatectomy (RP) between 1991 and 1999 and who had positive regional lymph nodes. We classified men as receiving adjuvant ADT if they received ADT within 120 days of RP, and we compared them to the men who had not received adjuvant ADT. We used propensity scores to balance potential confounders of receiving adjuvant ADT (ie, tumor characteristics, extent of nodal disease, demographics, receipt of radiation therapy) and Cox proportional hazard methods to measure the impact of adjuvant ADT on overall survival (OS), stratified by propensity score quintile. We conducted a sensitivity analysis that used 90, 150, 180, and 365 days as the definition for adjuvant ADT. Results A total of 731 men were identified, 209 of whom received ADT within 120 days of RP. There was no statistically significant difference in OS between the adjuvant ADT and non-ADT group (HR, 0.97; 95% CI, 0.71 to 1.27). There was no statistically significant survival difference with 90, 150, 180, and 365 days as the adjuvant ADT definition. Conclusion Deferring immediate ADT in men with positive lymph nodes after RP may not significantly compromise survival. Because observational studies should be considered hypothesis-generating studies, these results should be validated in a prospective fashion in a similar patient population.

Positron emission tomography/computed tomography to improve staging and restaging in Merkel cell carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8552-8552
Author(s):  
Elena B. Hawryluk ◽  
Kevin N. O'Regan ◽  
Niall Sheehy ◽  
Ye Guo ◽  
Andrew Dorosario ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Lymph Nodes ◽  
Emission Tomography ◽  
Merkel Cell ◽  
Regional Lymph Nodes ◽  
Positron Emission ◽  
Pet Ct ◽  
Bone Marrow Metastases

8552 Background: Merkel cell carcinoma (MCC) is a rare (~1,500 cases per year) and highly aggressive (33% mortality) cutaneous neuroendocrine carcinoma that occurs in older white patients on the UV-exposed skin of the head, neck, and extremities. As a patient’s stage at presentation is a strong predictor of survival, and there is a high propensity for locoregional recurrence and distant progression, imaging remains crucial for initial and subsequent management. There is, however, no consensus on the timing or method of imaging for MCC. Methods: We retrospectively reviewed 270 2-fluoro-[18F]-deoxy-2-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) scans performed in 97 patients at the Dana-Farber/Brigham and Women’s Cancer Center from August 2003 to December 2010. Results: The mean SUVmax was 6.5 for primary tumors, 6.4 for regional lymph nodes, 7.2 for distant metastases (all sites), 8.0 for bone/bone marrow metastases, and 9.4 for non-regional metastases in those patients with no identified primary. PET/CT imaging performed for initial management tended to upstage patients with more advanced disease (50% of stage IIIB patients). Metastases to bone/bone marrow (12 patients, 38%) was the 2nd most common site of distant spread after non-regional lymph nodes (19 patients, 59%), followed by skin (8 patients, 25%), liver (6 patients, 19%), lung/pleura (5 patients, 16%), adrenal (3 patients, 9%), muscle (3 patients, 9%), pancreas (2 patients, 6%), and peritoneum (1 patient, 3%). In 10 of 12 patients, PET identified bone/bone marrow metastases that were not seen on CT imaging, which resulted in either upstaging or initiation of more targeted palliative therapy. Conclusions: Added value of PET over CT, such as in the detection of bone/bone marrow metastases, may lead to more accurate staging, and thus prognostication, as well as earlier detection of relapse and initiation of salvage treatment. Its use should be considered in the staging and restaging of MCC.

scholarly journals Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Valeria Panebianco ◽  
Flavio Barchetti ◽  
Daniela Musio ◽  
Francesca De Felice ◽  
Camilla Proietti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Local Recurrence ◽  
Locoregional Recurrence ◽  
Specific Antigen ◽  
Cochrane Library ◽  
Published Data ◽  
Advanced Imaging ◽  
Pet Ct ◽  
The Impact

Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

scholarly journals The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

2021 ◽  
Vol 11 ◽  
Author(s):  
Jianhua Jiao ◽  
Zhiyong Quan ◽  
Jingliang Zhang ◽  
Weihong Wen ◽  
Jun Qin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Lymph Nodes ◽  
Clinical Decision Making ◽  
Care Hospital ◽  
Pelvic Region ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

PurposePLND (pelvic lymph node dissection)-validated nomograms are widely accepted clinical tools to determine the necessity of PLND by predicting the metastasis of lymph nodes (LNMs) in pelvic region. However, these nomograms are in lacking of a threshold to predict the metastasis of extrareolar lymph nodes beyond pelvic region, which is not suitable for PLND. The aim of this study is to evaluate a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases beyond pelvic region in high-risk prostate cancer patients, by using 68Ga-PSMA PET/CT as a reference to determine LN metastases (LNMs).Experimental DesignWe performed a retrospective analysis of 57 high-risk treatment-naïve PC patients in a large tertiary care hospital in China who underwent 68Ga-PSMA-617 PET/CT imaging. LNMs was detected by 68Ga-PSMA-617 PET/CT and further determined by imaging follow-up after anti-androgen therapy. The pattern of LN metastatic spread of PC patients were evaluated and analyzed. The impact of 68Ga-PSMA PET/CT on clinical decisions based on three clinical PLND-validated nomograms (Briganti, Memorial Sloan Kettering Cancer Center, Winter) were evaluated by a multidisciplinary prostate cancer therapy team. The diagnostic performance and the threshold of these nomograms in predicting extrareolar LNMs metastasis were evaluated via receiver operating characteristic (ROC) curve analysis.ResultsLNMs were observed in 49.1% of the patients by 68Ga-PSMA PET/CT, among which 65.5% of LNMs were pelvic-regional and 34.5% of LNMs were observed in extrareolar sites (52.1% of these were located above the diaphragm). The Briganti, MSKCC and Winter nomograms showed that 70.2%-71.9% of the patients in this study need to receive ePLND according to the EAU and NCCN guidelines. The LN staging information obtained from 68Ga-PSMA PET/CT would have led to changes of planned management in 70.2% of these patients, including therapy modality changes in 21.1% of the patients, which were mainly due to newly detected non-regional LNMs. The thresholds of nomograms to predict non-regional LNMs were between 64% and 75%. The PC patients with a score >64% in Briganti nomogram, a score >75% in MSKCC nomogram and a score >67% in Winter nomogram were more likely to have non-regional LNMs. The AUCs (Area under curves) of the clinical nomograms (Briganti, MSKCC and Winter) in predicting non-regional LNMs were 0.816, 0.830 and 0.793, respectively.ConclusionsBy using 68Ga-PSMA PET/CT as reference of LNM, the PLND-validated clinical nomograms can not only predict regional LNMs, but also predict non-regional LNMs. The additional information from 68Ga-PSMA PET/CT may provide added benefit to nomograms-based clinical decision-making in more than two-thirds of patients for reducing unnecessary PLND. We focused on that a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases with an AUC accuracy of about 80% after optimizing the simple nomograms which may help to improve the efficiency for PC therapy significantly in clinical practice.

Multisite experience of fluciclovine (18F) PET/CT imaging in biochemically recurrent prostate cancer: Impact of clinical factors and intersite variation.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 163-163
Author(s):  
Lucia Zanoni ◽  
Christina Nanni ◽  
Tore Bach-Gansmo ◽  
Trond V Bogsrud ◽  
Peter Nieh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Ct Scanning ◽  
Clinical Factors ◽  
Detection Rates ◽  
Prostate Bed ◽  
Pet Ct ◽  
Wide Range ◽  
The Impact ◽  
Baseline Psa

163 Background: Fluciclovine (18F) is an FDA-approved positron emission tomography/computerized tomography (PET/CT) tracer in clinical use for the detection and localization of biochemically recurrent (BCR) prostate cancer. Here, we report the impact of clinical factors and study site on its performance. Methods: In total, 596 subjects with BCR prostate cancer underwent fluciclovine (18F) PET/CT scanning at four sites in Italy, Norway and USA. Detection Rates (DR), including region level analyses, were stratified by prostate specific antigen (PSA) levels, PSA doubling time (PSAdt), Gleason score (GS), and by investigator/site. Extra-prostatic disease was defined as all positivity outside of residual prostate, prostate bed and seminal vesicles. Results: Fluciclovine (18F) PET/CT was positive in 67.7% (403/595) of subjects. Positive findings were detected in the prostate/bed and pelvic lymph node regions in 38.7% (232/599) and 32.6% (194/596) of scans, respectively. Metastatic involvement outside the pelvis was found in 26.2% (155/591) of scans. Generally, DR increased with increasing baseline PSA (Table 1). While subject level DR did not vary significantly with PSAdt (DR = 60-69% across all categories), a positive extra-prostatic scan was more likely in patients with shorter PSAdt (DR = 52%, 48%, 37% and 28% for PSAdt <3, 3-<6, 6-<12 and >12 months, respectively). Among 361 subjects for whom baseline GS was available, scores ≥9 were associated with the highest extra-prostatic DR (55%) compared with 23% in patients with GS ≤6. Inter-site variations in acquisition protocols may have impacted DR at low baseline PSA values; with subject level DR at PSA >0.2-0.5 ng/ml = 20%, 38%, 46% and 73% at site A, B, C and D, respectively. Conclusions: Fluciclovine (18F) can detect and localize BCR prostate cancer in a wide range of subjects and, with appropriate imaging protocols, has a clinically useful DR at PSA <0.5 ng/ml. Clinical trial information: NCT02443571. [Table: see text]

Identification of bone involvement in patients with prostate cancer recurrence using 18F-fluciclovine PET/CT and impact on subsequent management.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 248-248
Author(s):  
Michael S Kipper ◽  
Paul Dato ◽  
Keyword(s):  
Prostate Cancer ◽  
Prospective Trial ◽  
Specific Antigen ◽  
Cancer Recurrence ◽  
Bone Lesions ◽  
Curative Intent ◽  
Pet Tracer ◽  
Pet Ct ◽  
Prostate Cancer Recurrence ◽  
The Impact

248 Background: Bone is the most frequent site of metastasis in prostate cancer. Accurate localization of recurrence following primary treatment can help optimize salvage therapy. Positron emission tomography (PET) tracer, 18F-fluciclovine, is approved in Europe and the US for men with rising prostate specific antigen (PSA) after prior treatment. LOCATE was a prospective trial to study the impact of 18F-fluciclovine PET/computed tomography (PET/CT) on management of men with prostate cancer recurrence and negative standard imaging after curative intent treatment. Here, we explore changes in management (CIM) in men with 18F-fluciclovine-avid bone lesions. Methods: 18F-Fluciclovine PET/CT was performed and interpreted according to standard practice at 15 US centers. Eligible men (≥ 18 y; prior curative intent treatment of prostate cancer; recurrence based on rising PSA; negative/equivocal findings on standard bone and pelvic imaging) had their treatment plans recorded pre- and post-scan. Results: A total of 213 men (median pre-scan PSA, 1.0 ng/mL) were enrolled. Overall, 18F-fluciclovine detected lesions in 122 (57%) and 126 (59%) had CIM post-scan. 18F-Fluciclovine-avid bone lesions were found in 23 (11%) men. Prior to the fluciclovine scan, 21 (91%) had a 99mTc-MDP scan (20 negative, 1 equivocal results), 1 (4%) had an unspecified bone scan (negative result) and 1 (4%) did not receive a bone-specific scan. Of the 23 men with positive scans, 15 (65%) had post-scan CIM: ADT added to planned radiotherapy (RT; 4, 27%); ADT replaced with targeted treatment of fluciclovine-positive extrapelvic bony areas (4, 27%); RT modified to target fluciclovine-positive areas (4, 27%); modified ADT regime (2, 13%); and watchful waiting in favor of RT (1, 7%). The majority of men with no post-scan CIM were prescribed ADT (6/8, 75%). Conclusions: Despite negative standard bone imaging,18F-fluciclovine localized recurrence of prostate cancer to bone in 11% of patients; the majority of whom had a management change as a result, frequently in order to target fluciclovine-positive sites. Further study to investigate the clinical outcomes of such changes is warranted. Clinical trial information: NCT02680041.

scholarly journals Diagnostic performance of 18F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis

2020 ◽  
Vol 15 (6) ◽  
Author(s):  
Guillaume Chaussé ◽  
Noah Ben-Ezra ◽  
Michelle Stoopler ◽  
Jeremy Y. Levett ◽  
Tamim Niazi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Performance ◽  
Emission Tomography ◽  
Tumor Board ◽  
Recurrent Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Introduction: Conventional imaging (CI) performs poorly to identify sites of disease in biochemically recurrent prostate cancer. 68Ga-PSMA-11 positron emission tomography/ computed tomography (PET/CT) is most studied but has a very short half-life. This study reports the diagnostic performance of the novel prostate-specific membrane antigen (PSMA) radiotracer 18F-DCFPyL using real-life data, and tumor board simulation to estimate the impact of 18F-DCFPyL PET on patient management. Methods: Ninety-three 18F-DCFPyL PET/CT scans performed for patients previously treated for prostate cancer with a rising prostate-specific antigen (PSA) were retrospectively compared to contemporary CI, and clinical, imaging and PSA followups. A chart review was performed to document prior imaging, pathology results, serial serum PSA measurements, and other pertinent clinical data. Clinical utility of 18F-DCFPyL PET was measured using a simulated tumor board formed by three physicians with extensive prostate cancer experience deciding on management with and without knowledge of PET/CT results. Results: At median PSA 2.27 (interquartile range [IQR] 5.27], 82% of 18F-DCFPyL PET/CT demonstrated at least one site of disease: non-regional lymph nodes (37% of scans), regional lymph node metastases (28%), local recurrence (27%), bone metastases (20%), with higher PET positivity at higher PSA. Compared to 18F-DCFPyL PET/CT, CI showed overall poor performance, with accuracy below 20% for all extent of disease. PET/CT changed management in 44% of cases. The most frequent scenario was a radical change from initiating androgen deprivation therapy (ADT) to stereotactic body radiotherapy (SBRT) of oligo-lesional disease. In univariate and multivariate analysis, no patient characteristic could predict change of management by PET/CT results. Conclusions: 18F-DCFPyL significantly outperforms CI in recurring prostate cancer and is likely to impact management.

scholarly journals O uso do PET/CT com PSMA 68GA no reestadiamento do câncer prostático em pacientes com recidiva bioquímica após prostatectomia radical / The use of PET / CT with PSMA 68GA in prostate cancer rehability in patients with received biochemical after radical prostatectomy

2021 ◽  
Vol 66 (1u) ◽  
pp. 1
Author(s):  
Gesislania De Sousa ◽  
Erik Lima ◽  
Felipe Favaro Capeleti ◽  
Rafael Eidi Goto ◽  
Homero José de Farias e Melo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Treatment Change ◽  
Detection Rates ◽  
Therapeutic Decisions ◽  
Pubmed Database ◽  
Pet Ct ◽  
The Impact

Introdução: O Câncer de Próstata (CP) é o tumor maligno mais comum na população masculina acima dos 50 anos, sendo o adenocarcinoma o tipo histológico responsável por cerca de 95% dos casos. É o terceiro câncer com maior taxa de mortalidade entre os homens no mundo. A recorrência bioquímica do CP após prostatectomia radical é um problema clínico relevante. Objetivo: essa revisão teve como objetivo descrever o uso PET/CT-PSMA-68Ga no reestadiamento do CP nos casos de recidiva bioquímica após prostatectomia. Método: realizamos uma revisão bibliográfica na base de dados da PubMed, nos últimos três anos, de artigos publicados na íntegra. Resultados: Treze artigos foram usados na análise, a média da taxa de positividade do PET entre os estudos foi de 67.9%, variando de 34.4% a 89.5%. Discussão: todos os estudos concordam que maiores taxas de detecção foram diretamente proporcionais aos valores de PSA. Sete artigos mensuraram o impacto do PSMA na mudança terapêutica com uma média de 66.5% de alteração do tratamento (de 28.6% a 87.7%). Conclusão: Com base na análise dos artigos concluiu-se que o PET/CT-PSMA- - 68Ga na recorrência bioquímica do CP é útil na detecção de lesões locais e/ou metastáticas, e ainda importante no reestadiamento contribuindo nas decisões terapêuticas futuras.Palavras chave: Neoplasia prostática, Tomografia computadorizada, Recorrência, Bioquímica, PET/CT, Antígeno prostático específico Introduction: Prostate cancer (CP) is the most common malignant tumor in the male population over 50 years old, with adenocarcinoma being the histological type responsible for about 95% of cases. It is the third cancer with the highest mortality rate among men in the world. Biochemical recurrence of PC after radical prostatectomy is a relevant clinical problem. Objective: this review aimed to define the use of PET / CT-PSMA-68Ga without PC restaging in cases of biochemical recurrence after prostatectomy. Method: we performed a bibliographic review in the PubMed database, in the three years, of articles published in full. Results: Thirteen articles were used in the analysis, the average PET positivity rate between studies was 67.9%, varying from 34.4% to 89.5%. Discussion: all studies agree that higher detection rates were directly proportional to the PSA values. Seven articles measured the impact of PSMA on therapeutic change with an average of 66.5% of treatment change (from 28.6% to 87.7%). Conclusion: Based on the analysis of the concluded articles, PET / CT-PSMA-68Ga in the biochemical recurrence of PC is useful in the detection of sites and / or metastases, and also important in restaging, contributing to future therapeutic decisions. Keywords: Prostatic neoplasms, Computed tomography, Recurrence, Biochemistry, PET/CT, Prostate-specific antigen

scholarly journals Features of the physiological distribution of 68Ga-PSMA and its importance in the differential diagnosis of metastatic lesions of lymph nodes in patients with prostate cancer

2021 ◽  
Vol 12 (3) ◽  
pp. 80-86
Author(s):  
A. L. Dolbov ◽  
A. A. Stanjevskiy ◽  
E. V. Rozengauz
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Specific Antigen ◽  
Sympathetic Ganglia ◽  
Prostate Specific Membrane Antigen ◽  
Incorrect Choice ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Specific Membrane ◽  
Erroneous Interpretation

Introduction. The appearance of new radiopharmaceuticals based on prostate-specific membrane antigen has significantly increased the accuracy of prostate cancer diagnosis. The physiological accumulation of 68Ga-PSMA in the sympathetic ganglia is important in the diagnosis of metastatic lesions of the lymph nodes. Erroneous interpretation of images can lead to an incorrect choice of tactics for the treatment of prostate cancer.Purpose: improving the diagnosis of prostate cancer with the help of updated data on the physiological accumulation of 68GaPSMA. Identify the sources of potential errors in the interpretation of PET/CT with 68Ga-PSMA.Materials and methods. In order to stage the verified prostate cancer, PET was performed in our center/CT with 68Ga-PSMA in 109 men. All patients were divided into groups by the level of prostate-specific antigen, Gleason sum, and d’Amico.Results. In all patients, we observed the accumulation of RFP in the cervical, abdominal and presacral ganglia. The capture level of the radiotracer was in the range of SUV=1,6–2,3 (median SUV=1,9). In the control PET/CT study after treatment, the accumulation of RFP in the cervical, abdominal and presacral ganglia remained at the same values, which made it possible to identify the detected changes as a variant of the physiological norm.Conclusions. It is necessary to take into account the peculiarities of the physiological distribution and accumulation of radiotracer in organs and tissues, in particular, the capture of 68Ga-PSMA by sympathetic ganglia. This will avoid false-positive cases when describing PET-CT images and will make it possible to increase the informative value of the method.

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