Clinical management of PSMA-diagnostics in prostate carcinoma-importance of hybrid imaging using 68Ga-PSMA-PET/CT

Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Clinical management of PSMA-diagnostics in prostate carcinoma-importance of hybrid imaging using 68Ga-PSMA-PET/CT

Joint Event on 34th Euro-Global Summit on Cancer Therapy & Radiation Oncology & 6th International Conference on Big Data Analysis and Data Mining & 13th International Conference on Orthopedics, Arthroplasty and Rhe

July 25-27, 2019 London, UK

Manuela Andrea Hoffmann, HJ Wieler, J Müller-Hübenthal and M Schreckenberger

Bundeswehr Medical Service Headquarters, Germany
Bundeswehr Central Hospital, Germany
Johannes Gutenberg-University, Germany
Praxis im KölnTriangle, Germany

Scientific Tracks Abstracts: J Cancer Sci Ther

Abstract :

Background: Prostate cancer (PCa) is the second most common cancer in men worldwide. Several retrospective studies indicate that 68Ga-PSMA-PET/CT shows a superior detection capability compared with standard-of-care imaging, for detection of recurrent PCa and metastases. We evaluated the efficiency of this method to detect primary PCa with clinically relevant aggressive potential for guiding biopsy as well as surgery or radiotherapy.

Methods: Twenty-five patients with suspected PCa, based on an increased PSA level, were included in our study. Full-body scans were conducted 60 minutes after 68Ga-PSMA-11 injection. The radioligandsā?? uptake was quantified as maximum standardized uptake value (SUVmax). A prostate biopsy was performed in all patients. The results of PET/CT scans were compared with the histopathological results of the biopsy (defined as Gleason Score, GS).

Results: In 21 of 25 patients (84%), 68Ga-PSMA-11 PET/CT detected prostatic lesions suspected of being malignant (using a cut off-level of SUVmax>2.5). PCa with a GSā?„6 (low-grade and high-grade carcinoma) was confirmed by biopsy in all 21 cases. All high-grade PCa lesions (defined by GSā?„7b as high-grade and ā?¤7a as low-grade cancer) showed a SUVmax>12.0, which continued to increase with rising GS. The optimal cut off-level to distinguish GSā?¤7a versus GSā?„7b was determined by ROC analysis. A SUVmax of 5.4 was the optimal cut off-value (AUC=0.9692; 95% CI 0.9086; 1.000000; SD(AUC)=0.0309). Choosing this value, 68Ga-PSMA-11 PET/CT was able to distinguish between low- and high-grade PCa with a sensitivity of 84%, a specificity of 100%, a negative predictive value (NPV) of 67%, and an efficiency of 88% (p<0.001).

Conclusion: 68Ga-PSMA-11 PET/CT is a valuable imaging modality for the detection of primary PCa with a high efficiency for identifying clinically relevant aggressive cancer lesions and could help guiding biopsy and influence treatment decisions e.g. surgery or radiotherapy. Agus Trianto, Ocky Karna Radjasa, Rudhi Pribadi, Sekar Widyaningsih, Khoeruddin Wittriansyah, Isei Yusidharta, Wiratno, and Ita Riniatsih (2017) Exploration of Marine Sponges-Associated Fungi Producing Antifungal Compounds. Asian Journal of Microbiology Biotechnology & Environmental Science 19(3):588-593.

Biography :

Manuela Andrea Hoffmann is a Supervisory Center for Medical Radiation Protection, Bundeswehr Medical Service Headquarters, and Koblenz, Germany.



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