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68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls
BACKGROUND: 68Ga-PSMA PET/CT has an important role in assessment of prostate cancer patients with biochemical recurrence and is evolving in staging high- and intermediate risk disease. The aim of present study was to describe the metastatic patterns and frequency of involved sites of prostate cancer...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211573/ https://www.ncbi.nlm.nih.gov/pubmed/30382889 http://dx.doi.org/10.1186/s40644-018-0175-3 |
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author | Keidar, Zohar Gill, Ronit Goshen, Elinor Israel, Ora Davidson, Tima Morgulis, Maryna Pirmisashvili, Natalia Ben-Haim, Simona |
author_facet | Keidar, Zohar Gill, Ronit Goshen, Elinor Israel, Ora Davidson, Tima Morgulis, Maryna Pirmisashvili, Natalia Ben-Haim, Simona |
author_sort | Keidar, Zohar |
collection | PubMed |
description | BACKGROUND: 68Ga-PSMA PET/CT has an important role in assessment of prostate cancer patients with biochemical recurrence and is evolving in staging high- and intermediate risk disease. The aim of present study was to describe the metastatic patterns and frequency of involved sites of prostate cancer and to assess the incidence of benign Ga68-PSMA avid PET/CT findings in a large patient population. METHODS: 68Ga-PSMA PET/CT studies performed in two tertiary medical centers over a period of 24 months were retrospectively reviewed. The incidence and location of pathological 68Ga-PSMA avid foci, suspicious to represent malignancy, as well as those of unexpected benign foci of increased 68Ga-PSMA activity were documented and analyzed. RESULTS: There were 445 68Ga-PSMA studies in 438 men (mean age 72.4, range 51–92 years) with prostate cancer referred for biochemical failure (n = 270, 61%), staging high-risk disease (n = 112, 25%), response assessment (n = 30, 7%), follow-up (n = 22, 5%) and suspected bone metastases (n = 11, 2%). 68Ga-PSMA avid disease sites were observed in 319 studies (72%), in 181 studies (67%) for biochemical recurrence, 94 studies for staging (84%) (p < 0.05), in 22 studies for response assessment (73%), 10 follow up studies (45%) and in five patients with suspected bone metastases (45%). 68Ga-PSMA avid lesions were most commonly detected in the prostate (n = 193, 43%), loco-regional spread (n = 51, 11%), abdomino-pelvic nodes (n = 129, 29%) and distant metastases (n = 158, 36%), including bone metastases (n = 11, 25%), distant lymphadenopathy (n = 29, 7%) and other organs (n = 18, 4%). Distant 68Ga-PSMA-avid metastases were commonly seen in patients with biochemical recurrence (14/21 lesions), but were not seen in patient referred for staging (p < 0.013). There were 96 non-malignant 68Ga-PSMA avid foci in 81 studies, most common in reactive lymph nodes (n = 36, 38%), nonmalignant bone lesions (n = 21, 22%), thyroid nodules (n = 9, 9%), ganglions (n = 9, 9%) and lung findings (n = 8, 8%). CONCLUSION: The distribution of 68Ga-PSMA avid metastatic lesions is similar to data previously reported mainly from autopsy with comparable detection rates, indicating 68Ga-PSMA PET/CT is an accurate detection tool in patients with metastatic prostate cancer. If confirmed by further prospective studies 68Ga-PSMA PET/CT should be included in the guidelines to evaluate disease extent in these patients. |
format | Online Article Text |
id | pubmed-6211573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62115732018-11-08 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls Keidar, Zohar Gill, Ronit Goshen, Elinor Israel, Ora Davidson, Tima Morgulis, Maryna Pirmisashvili, Natalia Ben-Haim, Simona Cancer Imaging Research Article BACKGROUND: 68Ga-PSMA PET/CT has an important role in assessment of prostate cancer patients with biochemical recurrence and is evolving in staging high- and intermediate risk disease. The aim of present study was to describe the metastatic patterns and frequency of involved sites of prostate cancer and to assess the incidence of benign Ga68-PSMA avid PET/CT findings in a large patient population. METHODS: 68Ga-PSMA PET/CT studies performed in two tertiary medical centers over a period of 24 months were retrospectively reviewed. The incidence and location of pathological 68Ga-PSMA avid foci, suspicious to represent malignancy, as well as those of unexpected benign foci of increased 68Ga-PSMA activity were documented and analyzed. RESULTS: There were 445 68Ga-PSMA studies in 438 men (mean age 72.4, range 51–92 years) with prostate cancer referred for biochemical failure (n = 270, 61%), staging high-risk disease (n = 112, 25%), response assessment (n = 30, 7%), follow-up (n = 22, 5%) and suspected bone metastases (n = 11, 2%). 68Ga-PSMA avid disease sites were observed in 319 studies (72%), in 181 studies (67%) for biochemical recurrence, 94 studies for staging (84%) (p < 0.05), in 22 studies for response assessment (73%), 10 follow up studies (45%) and in five patients with suspected bone metastases (45%). 68Ga-PSMA avid lesions were most commonly detected in the prostate (n = 193, 43%), loco-regional spread (n = 51, 11%), abdomino-pelvic nodes (n = 129, 29%) and distant metastases (n = 158, 36%), including bone metastases (n = 11, 25%), distant lymphadenopathy (n = 29, 7%) and other organs (n = 18, 4%). Distant 68Ga-PSMA-avid metastases were commonly seen in patients with biochemical recurrence (14/21 lesions), but were not seen in patient referred for staging (p < 0.013). There were 96 non-malignant 68Ga-PSMA avid foci in 81 studies, most common in reactive lymph nodes (n = 36, 38%), nonmalignant bone lesions (n = 21, 22%), thyroid nodules (n = 9, 9%), ganglions (n = 9, 9%) and lung findings (n = 8, 8%). CONCLUSION: The distribution of 68Ga-PSMA avid metastatic lesions is similar to data previously reported mainly from autopsy with comparable detection rates, indicating 68Ga-PSMA PET/CT is an accurate detection tool in patients with metastatic prostate cancer. If confirmed by further prospective studies 68Ga-PSMA PET/CT should be included in the guidelines to evaluate disease extent in these patients. BioMed Central 2018-11-01 /pmc/articles/PMC6211573/ /pubmed/30382889 http://dx.doi.org/10.1186/s40644-018-0175-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Keidar, Zohar Gill, Ronit Goshen, Elinor Israel, Ora Davidson, Tima Morgulis, Maryna Pirmisashvili, Natalia Ben-Haim, Simona 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title | 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title_full | 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title_fullStr | 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title_full_unstemmed | 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title_short | 68Ga-PSMA PET/CT in prostate cancer patients – patterns of disease, benign findings and pitfalls |
title_sort | 68ga-psma pet/ct in prostate cancer patients – patterns of disease, benign findings and pitfalls |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211573/ https://www.ncbi.nlm.nih.gov/pubmed/30382889 http://dx.doi.org/10.1186/s40644-018-0175-3 |
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