The clinical efficacy of PSMA PET/MRI in biochemically recurrent prostate cancer compared with standard of care imaging modalities and confirmatory histopathology : results of a single-centre, prospective clinical trial
Prospective evidence for the clinical role and efficacy of prostate specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance imaging (MRI) combining MRI characterization and localization of lesions with PET avidity in comparison to conventional imaging is limited. In a prospective clinical trial, we aimed to evaluate the diagnostic yield and therapeutic impact of PSMA PET/MRI in men with biochemical recurrence (BCR) following curative therapy. A single-centre, prospective clinical trial at the Princess Alexandra Hospital recruited 30 patients with BCR. Patients underwent PSMA PET/MRI and concurrent conventional CT chest, abdomen, pelvis and whole-body bone scan. Biopsy was performed when safety possible for histological correlation of identified lesions. Clinical efficacy and impact of PSMA PET findings were evaluated. 30 patients with BCR were recruited (median PSA 0.69 ng/ml). PSMA avid lesions were present in 21 patients (70%). 23 patients were previously treated with definitive surgery, 6 patients received external beam radiotherapy and 1 patient had low dose rate brachytherapy. A total of 8 of 9 lesions biopsied were positive (88.9% histological correlation). PSMA PET/MRI detected local recurrence (p = 0.005) and pelvic lesions (p = 0.06) more accurately than conventional imaging. PSMA PET/MRI may be useful in staging men with biochemical recurrence, especially when PSA is low. Our data demonstrates a high detection rate, especially for locally recurrent disease, and highlights the role of this modality when PSA is low. This modality has the potential to significantly improve prostate cancer detection and may have implications for earlier salvage treatment, avoidance of futile local therapy and change patient management to lead to improved outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Clinical & experimental metastasis - 37(2020), 4 vom: 09. Aug., Seite 551-560 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Joshi, A [VerfasserIn] |
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| Links: |
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| Themen: |
Biochemical recurrence |
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| Anmerkungen: |
Date Completed 07.01.2021 Date Revised 28.06.2021 published: Print-Electronic ANZCTR: ACTRN12616000186459 Citation Status MEDLINE |
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| doi: |
10.1007/s10585-020-10043-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM310984076 |
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| 100 | 1 | |a Joshi, A |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The clinical efficacy of PSMA PET/MRI in biochemically recurrent prostate cancer compared with standard of care imaging modalities and confirmatory histopathology |b results of a single-centre, prospective clinical trial |
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| 500 | |a Date Revised 28.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Prospective evidence for the clinical role and efficacy of prostate specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance imaging (MRI) combining MRI characterization and localization of lesions with PET avidity in comparison to conventional imaging is limited. In a prospective clinical trial, we aimed to evaluate the diagnostic yield and therapeutic impact of PSMA PET/MRI in men with biochemical recurrence (BCR) following curative therapy. A single-centre, prospective clinical trial at the Princess Alexandra Hospital recruited 30 patients with BCR. Patients underwent PSMA PET/MRI and concurrent conventional CT chest, abdomen, pelvis and whole-body bone scan. Biopsy was performed when safety possible for histological correlation of identified lesions. Clinical efficacy and impact of PSMA PET findings were evaluated. 30 patients with BCR were recruited (median PSA 0.69 ng/ml). PSMA avid lesions were present in 21 patients (70%). 23 patients were previously treated with definitive surgery, 6 patients received external beam radiotherapy and 1 patient had low dose rate brachytherapy. A total of 8 of 9 lesions biopsied were positive (88.9% histological correlation). PSMA PET/MRI detected local recurrence (p = 0.005) and pelvic lesions (p = 0.06) more accurately than conventional imaging. PSMA PET/MRI may be useful in staging men with biochemical recurrence, especially when PSA is low. Our data demonstrates a high detection rate, especially for locally recurrent disease, and highlights the role of this modality when PSA is low. This modality has the potential to significantly improve prostate cancer detection and may have implications for earlier salvage treatment, avoidance of futile local therapy and change patient management to lead to improved outcomes | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Biochemical recurrence | |
| 650 | 4 | |a Nuclear medicine | |
| 650 | 4 | |a PSMA | |
| 650 | 4 | |a Prostate cancer | |
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| 700 | 1 | |a Roberts, M J |e verfasserin |4 aut | |
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| 700 | 1 | |a Rhee, H |e verfasserin |4 aut | |
| 700 | 1 | |a Pryor, D |e verfasserin |4 aut | |
| 700 | 1 | |a Lehman, M |e verfasserin |4 aut | |
| 700 | 1 | |a Heathcote, P |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, S |e verfasserin |4 aut | |
| 700 | 1 | |a Coucher, J |e verfasserin |4 aut | |
| 700 | 1 | |a Gustafson, S |e verfasserin |4 aut | |
| 700 | 1 | |a Miles, K |e verfasserin |4 aut | |
| 700 | 1 | |a Vela, I |e verfasserin |4 aut | |
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