Accuracy of 68Ga-PSMA PET/CT for lymph node and bone primary staging in prostate cancer

• Published in: Urologic oncology Vol. 40; no. 3; pp. 104.e17 - 104.e21
• Main Authors: Moreira, Larissa F., Mussi, Thais C., Cunha, Marcelo L. da, Filippi, Renée Z., Baroni, Ronaldo H.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.03.2022
• Subjects: Diagnostic imaging; Molecular imaging; Neoplasm staging; Positron-Emission tomography; Prostatic neoplasms; Molecular imaging; Diagnostic imaging; Prostatic neoplasms; Neoplasm staging; Positron-Emission tomography
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2021.11.007

•68Ga-PSMA PET/CT is a promising image modality in the primary stage of prostate cancer.•68Ga-PSMA PET/CT is a useful imaging method in the evaluation of patients with intermediate and high-risk prostate cancer.•The high specificity found by 68Ga-PSMA PET/CT for lymph node metastases suggests that the method can be used to guide treatment.•A negative 68Ga-PSMA PET/CT does not rule out microscopic lymph node metastasis. The aim of this study is to assess the accuracy of the 68Ga-PSMA PET/CT for lymph nodes and bones in the primary stage of prostate cancer. A total of 126 patients who were submitted to 68Ga-PSMA PET/CT from January 2016 to February 2019 for prostate cancer staging, detection of clinically significant lesions or active surveillance were included in this study. All studies were read by 2 experienced physicians (a nuclear physician and a radiologist). The reports were made in consensus and used by one of the authors to classify the exam in positive or negative. We evaluated presence of abnormal uptake in the prostate, lymph nodes, and bone. The reference standards were histopathological confirmation, confirmatory imaging exams and/or clinical follow-up showing lesion(s) regression after specific treatment, or typical osseous metastatic lesions and highly increased PSA levels. Measurement of diagnostic performance indicated a sensitivity, specificity and accuracy of 75%, 96.3%, and 90.8%, respectively, for lymph node involvement, and 90.9%, 50%, and 76.5%, respectively for metastatic bone lesions. This study showed high specificity and accuracy of 68Ga-PSMA PET/CT for lymph node and bone involvement in prostate cancer staging.