68Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study

Andrea Farolfi, Andrei Gafita, Jeremie Calais, Matthias Eiber, Ali Afshar-Oromieh, Fabian Spohn, Francesco Barbato, Manuel Weber, Harun Ilhan, Veronica Cervati, Axel Wetter, Boris Hadaschik, Alberto Briganti, Jochen Walz, Davide Pianori, Stefano Fanti, Uwe Haberkorn, Ken Herrmann, Wolfgang Peter Fendler

Research output: Contribution to journalArticle

Abstract

PURPOSE: Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68%) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35%) had disease confined to the pelvis while 57 of 173 (33%) had distant lesions. The most frequently affected nodal regions were the obturator in 42% and the presacral/mesorectal region in 40%. In 15 of the 33 patients (45%) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24%) had new lesions (positron emission tomography recurrence) and 10 (30%) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91%. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.

Original languageEnglish (US)
Pages (from-to)1174-1181
Number of pages8
JournalThe Journal of Urology
Volume202
Issue number6
DOIs
StatePublished - Dec 1 2019

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Residual Neoplasm
Diagnostic Imaging
Prostate-Specific Antigen
Prostatectomy
Positron-Emission Tomography
Multicenter Studies
Prostatic Neoplasms
Retrospective Studies
Neoplasm Metastasis
Ligands
(68Ga)Glu-urea-Lys(Ahx)-HBED-CC
Tomography
human glutamate carboxypeptidase II
Recurrence
Pelvis

Keywords

  • diagnostic imaging
  • neoplasm metastasis
  • positron-emission tomography
  • prostate specific antigen
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

68Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study. / Farolfi, Andrea; Gafita, Andrei; Calais, Jeremie; Eiber, Matthias; Afshar-Oromieh, Ali; Spohn, Fabian; Barbato, Francesco; Weber, Manuel; Ilhan, Harun; Cervati, Veronica; Wetter, Axel; Hadaschik, Boris; Briganti, Alberto; Walz, Jochen; Pianori, Davide; Fanti, Stefano; Haberkorn, Uwe; Herrmann, Ken; Fendler, Wolfgang Peter.

In: The Journal of Urology, Vol. 202, No. 6, 01.12.2019, p. 1174-1181.

Research output: Contribution to journalArticle

Farolfi, A, Gafita, A, Calais, J, Eiber, M, Afshar-Oromieh, A, Spohn, F, Barbato, F, Weber, M, Ilhan, H, Cervati, V, Wetter, A, Hadaschik, B, Briganti, A, Walz, J, Pianori, D, Fanti, S, Haberkorn, U, Herrmann, K & Fendler, WP 2019, '68Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study', The Journal of Urology, vol. 202, no. 6, pp. 1174-1181. https://doi.org/10.1097/JU.0000000000000417
Farolfi, Andrea ; Gafita, Andrei ; Calais, Jeremie ; Eiber, Matthias ; Afshar-Oromieh, Ali ; Spohn, Fabian ; Barbato, Francesco ; Weber, Manuel ; Ilhan, Harun ; Cervati, Veronica ; Wetter, Axel ; Hadaschik, Boris ; Briganti, Alberto ; Walz, Jochen ; Pianori, Davide ; Fanti, Stefano ; Haberkorn, Uwe ; Herrmann, Ken ; Fendler, Wolfgang Peter. / 68Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study. In: The Journal of Urology. 2019 ; Vol. 202, No. 6. pp. 1174-1181.
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abstract = "PURPOSE: Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68{\%}) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35{\%}) had disease confined to the pelvis while 57 of 173 (33{\%}) had distant lesions. The most frequently affected nodal regions were the obturator in 42{\%} and the presacral/mesorectal region in 40{\%}. In 15 of the 33 patients (45{\%}) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24{\%}) had new lesions (positron emission tomography recurrence) and 10 (30{\%}) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91{\%}. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.",
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T1 - 68Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study

AU - Farolfi, Andrea

AU - Gafita, Andrei

AU - Calais, Jeremie

AU - Eiber, Matthias

AU - Afshar-Oromieh, Ali

AU - Spohn, Fabian

AU - Barbato, Francesco

AU - Weber, Manuel

AU - Ilhan, Harun

AU - Cervati, Veronica

AU - Wetter, Axel

AU - Hadaschik, Boris

AU - Briganti, Alberto

AU - Walz, Jochen

AU - Pianori, Davide

AU - Fanti, Stefano

AU - Haberkorn, Uwe

AU - Herrmann, Ken

AU - Fendler, Wolfgang Peter

PY - 2019/12/1

Y1 - 2019/12/1

N2 - PURPOSE: Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68%) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35%) had disease confined to the pelvis while 57 of 173 (33%) had distant lesions. The most frequently affected nodal regions were the obturator in 42% and the presacral/mesorectal region in 40%. In 15 of the 33 patients (45%) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24%) had new lesions (positron emission tomography recurrence) and 10 (30%) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91%. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.

AB - PURPOSE: Prostate specific antigen persistence after radical prostatectomy is associated with adverse outcomes in patients with prostate cancer. We sought to define regions at risk for residual disease as well as the accuracy of prostate specific membrane antigen ligand positron emission tomography in patients with prostate specific antigen persistence. MATERIALS AND METHODS: At 6 participating centers a total of 191 patients who underwent 68Ga-prostate specific membrane antigen-11 positron emission tomography/computerized tomography or positron emission tomography/magnetic resonance imaging for persistently elevated postoperative prostate specific antigen (0.1 ng/ml or greater) were retrospectively included in study. The detection rate and the positive predictive value were determined. In 33 patients with additional prostate specific membrane antigen ligand positron emission tomography before prostatectomy we also determined the rate of positron emission tomography based persistence and recurrence. RESULTS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in 130 of 191 patients (68%) with prostate specific antigen persistence at a median prostate specific antigen of 1.1 ng/ml. The detection rate significantly increased with prostate specific antigen (p <0.001). Regarding prostate specific membrane antigen positron emission tomography/computerized tomography only 61 of 173 patients (35%) had disease confined to the pelvis while 57 of 173 (33%) had distant lesions. The most frequently affected nodal regions were the obturator in 42% and the presacral/mesorectal region in 40%. In 15 of the 33 patients (45%) with prostate specific membrane antigen ligand positron emission tomography before and after surgery at least 1 lesion was detected at baseline (positron emission tomography persistence), 8 (24%) had new lesions (positron emission tomography recurrence) and 10 (30%) had negative positron emission tomography findings. The positive predictive value of prostate specific membrane antigen ligand positron emission tomography was 91%. Systemic therapy initiation was significantly associated with distant lesions on prostate specific membrane antigen ligand positron emission tomography. CONCLUSIONS: Prostate specific membrane antigen ligand positron emission tomography localized prostate cancer in more than two-thirds of patients with high risk features and prostate specific antigen persistence after prostatectomy. Obturator and presacral/mesorectal nodes are at high risk for persistent metastasis.

KW - diagnostic imaging

KW - neoplasm metastasis

KW - positron-emission tomography

KW - prostate specific antigen

KW - prostatic neoplasms

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