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68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography for patients with favorable intermediate-risk prostate cancer.

Authors :
Dekalo, Snir
Kuten, Jonathan
Campbell, Jeffrey
Mintz, Ishai
Bar-Yosef, Yuval
Keizman, Daniel
Sarid, David
Even-Sapir, Einat
Yossepowitch, Ofer
Mano, Roy
Source :
Canadian Urological Association Journal. Jul2022, Vol. 16 Issue 7, p1-11. 11p.
Publication Year :
2022

Abstract

Introduction: Current guidelines don't support the use of pretreatment imaging in patients with favorable intermediate-risk prostate cancer. 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) is more accurate than conventional imaging for preoperative staging. We aimed to evaluate whether pretreatment 68Ga-PSMA PET/CT is beneficial for identifying pathological lymph node involvement (LNI) and adverse pathology among patients with favorable intermediate-risk prostate cancer. Methods: We reviewed 88 patients with favorable intermediate-risk prostate cancer who underwent 68Ga-PSMA PET/CT prior to radical prostatectomy and lymph node dissection from 2016-2020. The primary endpoint was the presence of pathological LNI. Association between pretreatment characteristics and outcomes were evaluated. Results: Preoperative 68Ga-PSMA PET/CT showed suspicious uptake in lymph nodes in 4/88 patients (5%), hence, 20 patients would need to be scanned to identify a patient with a positive lymph node on imaging. Two patients had pathological LNI, only one of whom showed 68Ga-PSMA PET/CT uptake prior to surgery. The sensitivity, specificity, positive predictive value, and negative predictive values of 68Ga-PSMA PET/CT for identifying LNI were 50%, 97%, 25%, and 99%, respectively. After surgery, four patients had evidence of prostate-specific antigen (PSA) persistence. The rate of PSA persistence was higher among patients with LNI on preoperative 68Ga-PSMA PET/CT (2/4, 50% vs. 2/84, 2%, p=0.009). Conclusions: Preoperative imaging of favorable intermediate-risk prostate cancer patients using 68Ga-PSMA PET/CT showed a low yield for identifying patients at higher risk. Consistent with current guidelines, our findings do not support the routine use of PET/CT in this group of patients. Future prospective studies are needed to validate our findings. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19116470
Volume :
16
Issue :
7
Database :
Academic Search Index
Journal :
Canadian Urological Association Journal
Publication Type :
Academic Journal
Accession number :
158219778
Full Text :
https://doi.org/10.5489/cuaj.7739