Cargando…
The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer
PURPOSE: To determine the impact on clinical management of patients with high-risk (HR) prostate cancer at diagnosis and patients with biochemical recurrence (BCR) using a new kit form of (68)Ga-prostate-specific membrane antigen (PSMA), namely tris(hydroxypyridinone) (THP)-PSMA, with positron emiss...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005085/ https://www.ncbi.nlm.nih.gov/pubmed/31872280 http://dx.doi.org/10.1007/s00259-019-04643-7 |
_version_ | 1783494857818374144 |
---|---|
author | Kulkarni, Meghana Hughes, Simon Mallia, Andrew Gibson, Victoria Young, Jennifer Aggarwal, Ajay Morris, Stephen Challacombe, Ben Popert, Rick Brown, Christian Cathcart, Paul Dasgupta, Prokar Warbey, Victoria S. Cook, Gary J. R. |
author_facet | Kulkarni, Meghana Hughes, Simon Mallia, Andrew Gibson, Victoria Young, Jennifer Aggarwal, Ajay Morris, Stephen Challacombe, Ben Popert, Rick Brown, Christian Cathcart, Paul Dasgupta, Prokar Warbey, Victoria S. Cook, Gary J. R. |
author_sort | Kulkarni, Meghana |
collection | PubMed |
description | PURPOSE: To determine the impact on clinical management of patients with high-risk (HR) prostate cancer at diagnosis and patients with biochemical recurrence (BCR) using a new kit form of (68)Ga-prostate-specific membrane antigen (PSMA), namely tris(hydroxypyridinone) (THP)-PSMA, with positron emission tomography-computed tomography (PET-CT). METHODS: One hundred eighteen consecutive patients (50 HR, 68 BCR) had management plans documented at a multidisciplinary meeting before (68)Ga-THP-PSMA PET-CT. Patients underwent PET-CT scans 60-min post-injection of (68)Ga-THP-PSMA (mean 159 ± 21.2 MBq). Post-scan management plans, Gleason score, prostate-specific antigen (PSA) and PSA doubling time (PSAdt) were recorded. RESULTS: HR group: 12/50 (24%) patients had management changed (9 inter-modality, 3 intra-modality). Patients with PSA < 20 μg/L had more frequent management changes (9/26, 34.6%) compared with PSA > 20 μg/L (3/24, 12.5%). Gleason scores > 8 were associated with detection of more nodal (4/16, 25% vs 5/31, 16.1%) and bone (2/16, 12.5% vs 2/31, 6.5%) metastases. BCR group: Clinical management changed in 23/68 (34%) patients (17 inter-modality, 6 intra-modality). Forty out of 68 (59%) scans were positive. Positivity rate increased with PSA level (PSA < 0.5 μg/L, 0%; PSA 0.5–1.0 μg/L, 35%; PSA 1.0–5.0 μg/L, 69%; PSA 5.0–10.0 μg/L, 91%), PSAdt of < 6 months (56% vs 45.7%) and Gleason score > 8 (78.9% vs 51.2%). CONCLUSIONS: (68)Ga-THP-PSMA PET-CT influences clinical management in significant numbers of patient with HR prostate cancer pre-radical treatment and is associated with PSA. Management change also occurs in patients with BCR and is associated with PSA and Gleason score, despite lower scan positivity rates at low PSA levels < 0.5 μg/L. |
format | Online Article Text |
id | pubmed-7005085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-70050852020-02-25 The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer Kulkarni, Meghana Hughes, Simon Mallia, Andrew Gibson, Victoria Young, Jennifer Aggarwal, Ajay Morris, Stephen Challacombe, Ben Popert, Rick Brown, Christian Cathcart, Paul Dasgupta, Prokar Warbey, Victoria S. Cook, Gary J. R. Eur J Nucl Med Mol Imaging Original Article PURPOSE: To determine the impact on clinical management of patients with high-risk (HR) prostate cancer at diagnosis and patients with biochemical recurrence (BCR) using a new kit form of (68)Ga-prostate-specific membrane antigen (PSMA), namely tris(hydroxypyridinone) (THP)-PSMA, with positron emission tomography-computed tomography (PET-CT). METHODS: One hundred eighteen consecutive patients (50 HR, 68 BCR) had management plans documented at a multidisciplinary meeting before (68)Ga-THP-PSMA PET-CT. Patients underwent PET-CT scans 60-min post-injection of (68)Ga-THP-PSMA (mean 159 ± 21.2 MBq). Post-scan management plans, Gleason score, prostate-specific antigen (PSA) and PSA doubling time (PSAdt) were recorded. RESULTS: HR group: 12/50 (24%) patients had management changed (9 inter-modality, 3 intra-modality). Patients with PSA < 20 μg/L had more frequent management changes (9/26, 34.6%) compared with PSA > 20 μg/L (3/24, 12.5%). Gleason scores > 8 were associated with detection of more nodal (4/16, 25% vs 5/31, 16.1%) and bone (2/16, 12.5% vs 2/31, 6.5%) metastases. BCR group: Clinical management changed in 23/68 (34%) patients (17 inter-modality, 6 intra-modality). Forty out of 68 (59%) scans were positive. Positivity rate increased with PSA level (PSA < 0.5 μg/L, 0%; PSA 0.5–1.0 μg/L, 35%; PSA 1.0–5.0 μg/L, 69%; PSA 5.0–10.0 μg/L, 91%), PSAdt of < 6 months (56% vs 45.7%) and Gleason score > 8 (78.9% vs 51.2%). CONCLUSIONS: (68)Ga-THP-PSMA PET-CT influences clinical management in significant numbers of patient with HR prostate cancer pre-radical treatment and is associated with PSA. Management change also occurs in patients with BCR and is associated with PSA and Gleason score, despite lower scan positivity rates at low PSA levels < 0.5 μg/L. Springer Berlin Heidelberg 2019-12-23 2020 /pmc/articles/PMC7005085/ /pubmed/31872280 http://dx.doi.org/10.1007/s00259-019-04643-7 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Kulkarni, Meghana Hughes, Simon Mallia, Andrew Gibson, Victoria Young, Jennifer Aggarwal, Ajay Morris, Stephen Challacombe, Ben Popert, Rick Brown, Christian Cathcart, Paul Dasgupta, Prokar Warbey, Victoria S. Cook, Gary J. R. The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title | The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title_full | The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title_fullStr | The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title_full_unstemmed | The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title_short | The management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)Ga-THP-PSMA) PET-CT imaging for high-risk and biochemically recurrent prostate cancer |
title_sort | management impact of (68)gallium-tris(hydroxypyridinone) prostate-specific membrane antigen ((68)ga-thp-psma) pet-ct imaging for high-risk and biochemically recurrent prostate cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005085/ https://www.ncbi.nlm.nih.gov/pubmed/31872280 http://dx.doi.org/10.1007/s00259-019-04643-7 |
work_keys_str_mv | AT kulkarnimeghana themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT hughessimon themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT malliaandrew themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT gibsonvictoria themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT youngjennifer themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT aggarwalajay themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT morrisstephen themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT challacombeben themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT popertrick themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT brownchristian themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT cathcartpaul themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT dasguptaprokar themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT warbeyvictorias themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT cookgaryjr themanagementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT kulkarnimeghana managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT hughessimon managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT malliaandrew managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT gibsonvictoria managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT youngjennifer managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT aggarwalajay managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT morrisstephen managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT challacombeben managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT popertrick managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT brownchristian managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT cathcartpaul managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT dasguptaprokar managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT warbeyvictorias managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer AT cookgaryjr managementimpactof68galliumtrishydroxypyridinoneprostatespecificmembraneantigen68gathppsmapetctimagingforhighriskandbiochemicallyrecurrentprostatecancer |