Cargando…

Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study

BACKGROUND: To evaluate the impact of Gallium-68 [(68)Ga] labeled prostate specific membrane antigen (PSMA) positron emission tomography (PET)/X-ray computed tomography (CT) compared with conventional imaging on staging and clinical management of men evaluated for primary prostate cancer (PCa). METH...

Descripción completa

Detalles Bibliográficos
Autores principales: Donswijk, Maarten L., van Leeuwen, Pim J., Vegt, Erik, Cheung, Zing, Heijmink, Stijn W. T. P. J., van der Poel, Henk G., Stokkel, Marcel P. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409439/
https://www.ncbi.nlm.nih.gov/pubmed/32758168
http://dx.doi.org/10.1186/s12885-020-07192-7
_version_ 1783568063036129280
author Donswijk, Maarten L.
van Leeuwen, Pim J.
Vegt, Erik
Cheung, Zing
Heijmink, Stijn W. T. P. J.
van der Poel, Henk G.
Stokkel, Marcel P. M.
author_facet Donswijk, Maarten L.
van Leeuwen, Pim J.
Vegt, Erik
Cheung, Zing
Heijmink, Stijn W. T. P. J.
van der Poel, Henk G.
Stokkel, Marcel P. M.
author_sort Donswijk, Maarten L.
collection PubMed
description BACKGROUND: To evaluate the impact of Gallium-68 [(68)Ga] labeled prostate specific membrane antigen (PSMA) positron emission tomography (PET)/X-ray computed tomography (CT) compared with conventional imaging on staging and clinical management of men evaluated for primary prostate cancer (PCa). METHODS: Men with newly diagnosed biopsy-proven PCa who had been staged with a conventional staging protocol including bone scintigraphy (BS) and additionally underwent [(68)Ga]PSMA PET/CT, were evaluated retrospectively. Imaging findings from BS, magnetic resonance imaging (MRI) and/or CT were categorized regarding locoregional nodal (N) and distant metastasis (M) status as negative, positive or equivocal before and after addition of the information of PET/CT. Also, the imaging-based level of confidence (LoC) in correct assessment of N and M status was scored. Impact of PET/CT on clinical management was evaluated by the percentage of treatment category changes after PET/CT as determined in the multidisciplinary tumour board. RESULTS: Sixty-four men with intermediate and high-risk PCa were evaluated. With additional information of PET/CT, N status was upstaged in 23%, and downstaged in 9%. M status was upstaged in 13%, and downstaged in 23%. A net increase in LoC of 20% was noted, mainly regarding M status. Treatment category changed from palliative to curative in 9%, and from curative to palliative in 3%. An undecided treatment plan changed to curative in 14%, as well as to palliative in another 9%. In total, a 36% treatment category change was noted. High negative predictive value of PET/CT for M status was indicated by 27 patients that underwent robot-assisted radical prostatectomy and reached postoperative biochemical disease-free status or had a likely other site of disease recurrence. CONCLUSIONS: PSMA PET/CT can cause considerable changes in N and M staging, as well as in management compared to conventional staging. Findings of this study support the replacement of BS and CT by PSMA PET/CT in staging primary PCa.
format Online
Article
Text
id pubmed-7409439
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-74094392020-08-07 Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study Donswijk, Maarten L. van Leeuwen, Pim J. Vegt, Erik Cheung, Zing Heijmink, Stijn W. T. P. J. van der Poel, Henk G. Stokkel, Marcel P. M. BMC Cancer Research Article BACKGROUND: To evaluate the impact of Gallium-68 [(68)Ga] labeled prostate specific membrane antigen (PSMA) positron emission tomography (PET)/X-ray computed tomography (CT) compared with conventional imaging on staging and clinical management of men evaluated for primary prostate cancer (PCa). METHODS: Men with newly diagnosed biopsy-proven PCa who had been staged with a conventional staging protocol including bone scintigraphy (BS) and additionally underwent [(68)Ga]PSMA PET/CT, were evaluated retrospectively. Imaging findings from BS, magnetic resonance imaging (MRI) and/or CT were categorized regarding locoregional nodal (N) and distant metastasis (M) status as negative, positive or equivocal before and after addition of the information of PET/CT. Also, the imaging-based level of confidence (LoC) in correct assessment of N and M status was scored. Impact of PET/CT on clinical management was evaluated by the percentage of treatment category changes after PET/CT as determined in the multidisciplinary tumour board. RESULTS: Sixty-four men with intermediate and high-risk PCa were evaluated. With additional information of PET/CT, N status was upstaged in 23%, and downstaged in 9%. M status was upstaged in 13%, and downstaged in 23%. A net increase in LoC of 20% was noted, mainly regarding M status. Treatment category changed from palliative to curative in 9%, and from curative to palliative in 3%. An undecided treatment plan changed to curative in 14%, as well as to palliative in another 9%. In total, a 36% treatment category change was noted. High negative predictive value of PET/CT for M status was indicated by 27 patients that underwent robot-assisted radical prostatectomy and reached postoperative biochemical disease-free status or had a likely other site of disease recurrence. CONCLUSIONS: PSMA PET/CT can cause considerable changes in N and M staging, as well as in management compared to conventional staging. Findings of this study support the replacement of BS and CT by PSMA PET/CT in staging primary PCa. BioMed Central 2020-08-05 /pmc/articles/PMC7409439/ /pubmed/32758168 http://dx.doi.org/10.1186/s12885-020-07192-7 Text en © The Author(s) 2020 Open AccessThis 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/. 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 in a credit line to the data.
spellingShingle Research Article
Donswijk, Maarten L.
van Leeuwen, Pim J.
Vegt, Erik
Cheung, Zing
Heijmink, Stijn W. T. P. J.
van der Poel, Henk G.
Stokkel, Marcel P. M.
Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title_full Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title_fullStr Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title_full_unstemmed Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title_short Clinical impact of PSMA PET/CT in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
title_sort clinical impact of psma pet/ct in primary prostate cancer compared to conventional nodal and distant staging: a retrospective single center study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409439/
https://www.ncbi.nlm.nih.gov/pubmed/32758168
http://dx.doi.org/10.1186/s12885-020-07192-7
work_keys_str_mv AT donswijkmaartenl clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT vanleeuwenpimj clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT vegterik clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT cheungzing clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT heijminkstijnwtpj clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT vanderpoelhenkg clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy
AT stokkelmarcelpm clinicalimpactofpsmapetctinprimaryprostatecancercomparedtoconventionalnodalanddistantstagingaretrospectivesinglecenterstudy