Impact of Targeted Molecular Imaging with 18F-PSMA-1007 PET/CT in Multimodal Evaluation of Prostate Cancer

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Background. According to the European Urology Association, prostate cancer remains the second most commonly diagnosed cancer in men, accounting for 15% of all cancers diagnosed. Accurate localization of recurrent prostate cancer is a major challenge, it can be assessed by magnetic resonance imaging (MRI) and positron emission tomography in combination with computer tomography (PET/CT).
Aim. The aim of this study was to compare the diagnostic tools – 18F-PSMA-1007 PET/CT and MRI for evaluation of local recurrence and regional lymph nodes. Radiopharmaceutical 18F-PSMA-1007 is a ligand, used in PET/CT, and it has some advantageous characteristics in recurrent prostate cancer diagnostics.
Methods. This comparative prospective study included 29 prostate cancer patients (mean age 66.83±6.76 years) with biochemical relapse referred for 18F-PSMA PET/CT, who were previously treated with radical prostatectomy and/or radiation therapy of the prostate bed. The probability of a 18F-PSMA-1007 PET/CT scan suggestive of pathology was compared with MRI Imaging results, PSA level and Gleason score (GS). Clinical data of patients and/or follow-up information were used as the reference standard.
Results. PET/CT confirmed pathological findings in 20/29 patients, 69%, respectively. The overall mean PSA level in the study group was 2.48 ng/ml (range 0.16–13.1 ng/ml). The mean PSA level in PET- positive finding group was higher than in PET-negative finding group (3 ng/ml vs. 1.3 ng/ml), but without statistically significant correlation (rs=0,33; p=0,08). The mean PSA doubling time – 10.4 months, the median Gleason score was 7 (range 5–9), and 72% (N=21) had a score above 7 (with prevalence of 3+4), the rate of pathological scans in these patients was 80% (N=17).
Local recurrence findings were detected by PET/CT in 35 % (n=10/29), in MRI – 31% (n=9/29). Nodal involvement was evaluated by PET/CT and MRI in 48% (n=14/29) and 28% (n=8/29). Overall method sensitivity was for 18F -PSMA-1007 PET/CT and MRI for local recurrence 90.9% vs. 81.8% and for regional lymph nodes sensitivity 92.9% vs. 57.1%.
Conclusion. This study results revealed 18F -PSMA-1007 PET/CT as superior diagnostic tool to MRI for evaluation of recurrent prostate cancer. Results are highly dependent on PSA level increase and Gleason score, confirming result stability in the groups with GS >7.
Acknowledgements. The authors declare the absence of conflict of interest.

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)


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