PET/CT WITH 68GA-PSMA-11 IN DETECTION OF PRIMARY TUMOR AND RECURRENCE OF PROSTATE CANCER

2018 ◽  
Vol 64 (6) ◽  
pp. 799-804
Author(s):  
Darya Ryzhkova ◽  
M. Poyda
Keyword(s):  
Prostate Cancer ◽  
Primary Tumor ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Negative Results ◽  
Primary Prostate Cancer ◽  
Pet Ct ◽  
The Relationship ◽  
Positive Results ◽  
T Category

Purpose: To study the diagnostic value of PET-CT with 68Ga-PSMA-11 in the diagnosis of a primary prostate cancer, preoperative staging, and the detection of recurrence of prostate cancer (PCa). Methods: 28 patients aged 64.7 ± 8.74 years were included. 10 patients primary prostate cancer, and 18 patients with biochemical recurrence of the disease after radical treatment were examined. All patients underwent PET-CT with 68Ga-PSMA-11 according the whole body protocol. Interpretation of images was performed visually and quantitatively by calculation of SUL max. Results: High focal or diffuse 68Ga-PSMA-11 uptake was found in prostate parenchyma in patients with primary prostate cancer. Additionally metastases in regional lymph nodes were diagnosed in 4 patients and bone metastases were found in one patient. The correlation between 68Ga-PSMA-11 uptake level and Gleason index in the primary tumor (R Spearmen = 0.25, p = 0.57) was not observed. PET-positive results were obtained in 14 patients and PET-negative results in 4 patients with biochemical recurrence of PCa. The relationship between the frequency of PET-positive results and Gleason index was not revealed (R Spearmen = 0.2, p = 0.39). We found a weak but significant correlation between the frequency of PET-positive results and the prostate tumor stage according to the T category (R Spearmen = 0.49, p = 0.049). In patients with low values of PSA (less than 1.0 ng/ml) in 4 out of 9 cases, PET-negative results were obtained. In patients with PSA level more than 1.0 ng/ml PET-positive results were obtained in all cases. Conclusions: PET/CT with 68Ga-PSMA-11 allows to diagnose the primary prostate cancer, to establish the stage of the disease in categories N and M, and also to determine the localization and dissemination of the tumor in patients with biochemical recurrence of prostate cancer. The relationship between 68Ga-PSMA-11 uptake in primary tumor and Gleason index was not found. The probability of obtaining PET-positive results in cases of biochemical recurrence is affected by a PSA level above 1 ng/ml and a high stage of the disease according to the T category (T3-T4).

scholarly journals F18 NaF PET/CT and whole body MRI for the detection of metastases in patients with biochemical recurrence of prostate cancer

2016 ◽  
Vol 27 ◽  
pp. vi260
Author(s):  
P. Twardowski ◽  
S.K. Pal ◽  
C. Stein ◽  
P. Frankel ◽  
H. Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pet Ct

Evaluation of whole-body tumor burden with 68Ga-PSMA PET/CT in the biochemical recurrence of prostate cancer

2019 ◽  
Vol 33 (5) ◽  
pp. 344-350 ◽  
Author(s):  
A. E. T. Brito ◽  
F. A. Mourato ◽  
R. P. M. de Oliveira ◽  
A. L. G. Leal ◽  
P. J. A. Filho ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Tumor Burden ◽  
Whole Body ◽  
Psma Pet ◽  
Pet Ct

Role of pet/ct in detection of tumor of unknown origin

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khadija R Elsayed ◽  
Khaled E Allam ◽  
Omar F Kamel ◽  
Ahmed H Soliman ◽  
Huda F Elsayed
Keyword(s):  
Primary Tumor ◽  
Predictive Value ◽  
Unknown Origin ◽  
Whole Body ◽  
Unknown Primary ◽  
Primary Tumors ◽  
Negative Results ◽  
Number Of Patients ◽  
Pet Ct

Abstract Purpose To evaluate the role of combined positron emission tomography and computed tomography (PET/CT) imaging in the detection of tumors of unknown origin. Methods This study included 20 cases presented with pathologically proved metastases of unknown primary or with clinic-radiological suspicion of metastases with unknown primary. Results The number of patients with true positive primary tumor sites was 14 (70%), 2 patients with false-positive results (10%), 2 patients with true negative results (10%) and 2 patients with false-negative results (10%). A sensitivity of 87.5% was achieved, with a specificity of 50% and a total accuracy of 80%. The Positive predictive value was 87.5%%, while the negative predictive value was 50%. The detection rate of the origin of the primary tumor was 70%. Conclusion whole-body FDG-PET/CT has to be considered a useful tool in evaluating metastases from UPT, allowing identification of primary tumors and modifying the stage of the disease and affect the management.

scholarly journals Early differences in dynamic uptake of 68Ga-PSMA-11 in primary prostate cancer: A test-retest study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246394
Author(s):  
J. olde Heuvel ◽  
B. J. de Wit-van der Veen ◽  
M. Sinaasappel ◽  
C. H. Slump ◽  
M. P. M. Stokkel
Keyword(s):  
Prostate Cancer ◽  
Iliac Artery ◽  
Prostate Tumor ◽  
Whole Body ◽  
Time Interval ◽  
Tumor Uptake ◽  
Gluteal Muscle ◽  
Time Activity ◽  
Primary Prostate Cancer ◽  
Pet Ct

Introduction Dynamic PET/CT allows visualization of pharmacokinetics over the time, in contrast to static whole body PET/CT. The objective of this study was to assess 68Ga-PSMA-11 uptake in pathological lesions and benign tissue, within 30 minutes after injection in primary prostate cancer (PCa) patients in test-retest setting. Materials and methods Five patients, with biopsy proven PCa, were scanned dynamically in list mode for 30 minutes on a digital PET/CT-scanner directly after an intravenous bolus injection of 100 MBq 68Ga-PSMA-11. Approximately 45 minutes after injection a static whole body scan was acquired, followed by a one bed position scan of the pelvic region. The scans were repeated approximately four weeks later, without any intervention in between. Semi-quantitative assessment was performed using regions-of-interest in the prostate tumor, bladder, gluteal muscle and iliac artery. Time-activity curves were extracted from the counts in these regions and the intra-patient variability between both scans was assessed. Results The uptake of the iliac artery and gluteal muscle reached a plateau after 5 and 3 minutes, respectively. The population fell apart in two groups with respect to tumor uptake: in some patients the tumor uptake reached a plateau after 5 minutes, whereas in other patients the uptake kept increasing, which correlated with larger tumor volumes on PET/CT scan. Median intra-patient variation between both scans was 12.2% for artery, 9.7% for tumor, 32.7% for the bladder and 14.1% for the gluteal muscle. Conclusion Dynamic 68Ga-PSMA-11 PET/CT scans, with a time interval of four weeks, are reproducible with a 10% variation in uptake in the primary prostate tumor. An uptake plateau was reached for the iliac artery and gluteal muscle within 5 minutes post-injection. A larger tumor volume seems to be related to continued tumor uptake. This information might be relevant for both response monitoring and PSMA-based radionuclide therapies.

Innovative Tracer in der onkologischen Diagnostik

2010 ◽  
Vol 49 (S 01) ◽  
pp. S41-S45 ◽  
Author(s):  
S. Schwarzenböck ◽  
M. Schwaiger ◽  
B. J. Krause
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Surrogate Marker ◽  
Biological Information ◽  
Whole Body ◽  
Great Promise ◽  
Primary Therapy ◽  
Choline Pet ◽  
Pet Ct ◽  
Tumour Oxygenation

SummaryIn oncology, PET and PET/CT with tracers beyond FDG target more specific biological processes, such as proliferation (18F-3'-fluoro-3'-deoxy-L-thymidine; 18F-FLT), tumour hypoxia (18F-fluoromisonidazol; 18F-FMISO) and phospholipid metabolism (radioactively labelled choline derivates).FLT is a thymidine analogue which can be labelled with 18F. PET with 18F-FLT enables to non-invasively image and to quantify the proliferation fraction of tumours. Proliferation dependent accumulation of FLT has been demonstrated for a variety of solid and haematologic neoplasms including lung cancer, breast cancer, gastric cancer, colorectal cancer and malignant lymphoma. Furthermore, FLT has been suggested as surrogate marker for the assessment of response to treatment, especially when targeted drugs are utilized.PET imaging in particular has emerged as a promising non-invasive tool to accurately characterize tumour oxygenation. The great promise of PET/CT is its potential as a single imaging modality for whole body staging that provides anatomical and biological information on the disease as a whole. It allows a more precise estimation of the hypoxic tumour volume as well as comparisons on a voxel-by-voxel basis (parametric mapping). PET and PET/CT with hypoxia tracers thus offer the potential to optimize and individualize therapy for patients suffering from cancer. PET- and PET/CT-studies using 11C- or 18Flabeled choline derivates recently have shown promising results for re-staging prostate cancer in patients with biochemical recurrence and advanced prostate cancer. In patients with biochemical recurrence of prostate cancer after primary therapy the detection rate of 11C-choline-PET/CT shows a positive relationship with serum PSA-levels. In these patients 11C-choline PET/CT allows not only to diagnose but also to localize recurrent disease with implications on disease management (localised vs. systemic therapy). Conclusion: The clinical success of multimodal imaging with PET/CT is expected to promote the combination of MRI and PET in the future.

scholarly journals Comparison of Early Imaging and Imaging 60 min Post-Injection after Forced Diuresis with Furosemide in the Assessment of Local Recurrence in Prostate Cancer Patients with Biochemical Recurrence Referred for 68Ga-PSMA-11 PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1191
Author(s):  
Steffen Bayerschmidt ◽  
Christian Uprimny ◽  
Alexander Stephan Kroiss ◽  
Josef Fritz ◽  
Bernhard Nilica ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Pet Imaging ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Post Injection ◽  
Forced Diuresis ◽  
Pet Ct ◽  
Negative Findings ◽  
Static Imaging

Background: 68Ga-PSMA-11 PET/CT is a promising method for the assessment of local recurrence (LR) in prostate cancer (PCa) patients. The aim of this study was to evaluate the diagnostic performance of early 68Ga-PSMA-11 PET imaging in comparison to 68Ga-PSMA-11 PET imaging 60 min post-injection (p.i.) in the detection of LR in patients with biochemical recurrence (BR) of prostate carcinoma. Materials and Methods: 190 image sets of patients with BR in PCa who underwent 68Ga-PSMA-11 PET/CT were assessed retrospectively (median prostate specific antigen (PSA) value, 0.70 ng/mL (range, 0.1–105.6 ng/mL)). Patients received an early static scan of the pelvic area (median, 248 s p.i. (range, 56–923 s)) and a whole-body scan 60 min p.i. (median, 64 min p.i. (range, 45–100 min)) with intravenous administration of 20 mg furosemide i.v. at the time of tracer application, followed by intravenous hydration with 500 mL of sodium chloride (NaCl 0.9%). Assessment was based on visual analysis and calculation of the maximum standardized uptake value (SUVmax) of the pathologic lesions present in the prostate fossa found in the early PET imaging and 60 min PET scans. The scans were characterized as negative, positive, or equivocal. The results were compared, and the combination of early and 60 min p.i. imaging was evaluated. Results: Image assessment resulted in 30 (15.8%) positive, 17 (8.9%) equivocal, and 143 (75.3%) negative findings in early scans, and 28 (14.7%) positive, 25 (13.2%) equivocal, and 137 (72.1%) negative findings of LR in 60 min p.i. images. For combined image analysis, 33 (17.4%) cases were positive and 20 (10.5%) were equivocal. There was no statistical significance between the number of positive (p = 0.815), negative (p = 0.327), and equivocal (p = 0.152) findings. Furthermore, the combination of both scans showed no statistically significant differences for the positive and negative findings (p = 0.063). The median SUVmax was 4.9 (range, 2.0–55.2) for positive lesions in the early scans and 8.0 (range, 2.1–139.9) in the scans 60 min p.i. The median SUVmax for bladder activity was 2.5 (range, 0.9–12.2) in the early scans and 8.2 (range, 1.8–27.6) in the scans 60 min p.i. Conclusion: Early static imaging additional to 68Ga-PSMA-11 PET images acquired 60 min p.i. has limited value in patients prepared with furosemide and hydration, and showed no statistically significant change in the detection rate (DR) of LR and the number of equivocal findings. Based on our results, in departments following a protocol with forced diuresis, including furosemide, additional early static imaging cannot be routinely recommended for the assessment of BR in PCa patients.

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