The impact of 68GA-PSMA PET/CT on therapy management of high risk prostate cancer

• Published in: İstanbul Tıp Fakültesi Dergisi Vol. 84; no. 1; pp. 48 - 56
• Main Authors: Has Şimşek,Duygu, Işık,Emine Göknur, Civan,Caner, Özkan,Zeynep Gözde, Kuyumcu,Serkan, İribaş,Ayça, Şanlı,Mehmet Öner, Şanlı,Yasemin
• Format: Journal Article
• Language: English
• Published: İstanbul Üniversitesi Yayınları 01-01-2021
• Subjects: Tıp; İstanbul; Türkiye; prostate cancer; prostat kanseri; therapy management; 68Ga-PSMA PET/BT; evreleme; 68Ga-PSMA PET/CT; tedavi yönetimi; staging
• ISSN: 1305-6441
• DOI: 10.26650/IUITFD.2020.831103

Objective: We evaluated the impact of 68Ga-PSMA PET/CT
(PSMA PET) on therapy management of newly diagnosed highrisk
prostate cancer (PCa).
Material and Method: Patients who underwent a PSMA PET for
primary staging of high-risk PCa were evaluated retrospectively.
Patients had abdominopelvic CT (n=126), pelvic MRI (n=42)
and bone scintigraphy (BS) (n=40) prior to PSMA PET. All clinical,
biochemical, and imaging data were documented. Increased
PSMA uptakes related to PCa were documented according to
previously described PSMA-RADS version 1.0 based on a fivepoint
scale. The impact of PSMA PET on patient management
was evaluated through pre and post PET/CT questionnaires, retrospectively.
Management changes were categorized as inter or
intramodality change, based on PSMA PET results. Paired samples
t-test was used to compare subgroups in SPSS version 24.0
software. A p-value <0.05 was considered significant.
Results: A total of 126 patients were included in the study. The
median PSA level was 30.8 ng/ml (95%CI: 2.1-268.6 ng/ml) and
median GS was 8 (range: 6-10). Based on the PSMA PET findings,
41 patients (32.5%) had more extensive disease and 2 patients
(1.6%) had less extensive disease. Overall, therapy management
was changed in 38 patients (30.1%). Intermodality changes occurred
in 29 patients (23%), and intramodality changes occurred
in 9 patients (7.1%). The change in management was similar in
patients with BS and without BS, 30% vs. 30.2%.
Conclusion: PSMA PET impacted the therapy management in
almost one-third of patients in high-risk PCa even though they had already been staged with standard imaging modalities.