68Gallium-labelled PSMA-PET/CT as a diagnostic and clinical decision-making tool in Asian prostate cancer patients following prostatectomy
OBJECTIVEProstate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk stratification tool for Asian men with rapid biochemical recurrence (BCR) following radical prostatectomy (RadP). This study aims to assess the detection r...
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Abstract | OBJECTIVEProstate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk stratification tool for Asian men with rapid biochemical recurrence (BCR) following radical prostatectomy (RadP). This study aims to assess the detection rate of 68Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-RadP. METHODS68Ga PSMA-PET and CT body with/without bone scan [conventional workup (CWU)] were performed in 55 Asian patients with BCR within 36 months post-RadP. Two blinded reviewers assessed the images. Detection rates of 68Ga PSMA-PET/CT were evaluated, and impact on management was reviewed by comparison with CWU. RESULTSMedian time to BCR post-RadP was 8.1 months. Detection rate for 68Ga PSMA-PET/CT was 80% (44/55). A positive scan was significantly associated with increasing prostate-specific antigen (PSA) level [odds ratio (OR) = 1.13 (95% CI 1.05-1.30), P = 0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, 68Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44 (56.8%) patients: 10 to hormonal therapy (HT) and whole pelvis radiotherapy (RT) in addition to bed RT, and 15 to palliative HT alone. CONCLUSIONSIn the present report, we demonstrated the diagnostic and treatment decision utility of 68Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels (< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease. |
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AbstractList | Objective Prostate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk stratification tool for Asian men with rapid biochemical recurrence (BCR) following radical prostatectomy (RadP). This study aims to assess the detection rate of 68Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-RadP.Methods 68Ga PSMA-PET and CT body with/without bone scan [conventional workup (CWU)] were performed in 55 Asian patients with BCR within 36 months post-RadP. Two blinded reviewers assessed the images. Detection rates of 68Ga PSMA-PET/CT were evaluated, and impact on management was reviewed by comparison with CWU. Results Median time to BCR post-RadP was 8.1 months. Detection rate for 68Ga PSMA-PET/CT was 80% (44/55). A positive scan was significantly associated with increasing prostate-specific antigen (PSA) level [odds ratio (OR) = 1.13 (95% CI 1.05–1.30), P = 0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, 68Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44 (56.8%) patients: 10 to hormonal therapy (HT) and whole pelvis radiotherapy (RT) in addition to bed RT, and 15 to palliative HT alone. Conclusions In the present report, we demonstrated the diagnostic and treatment decision utility of 68Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels (< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease. Objective:Prostate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence (BCR) following radical prostatectomy (RadP).This study aims to assess the detection rate of 68Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-RadP.Methods:68Ga PSMA-PET and CT body with/without bone scan [conventional workup (CWU)] were performed in 55 Asian patients with BCR within 36 months post-RadP.Two blinded reviewers assessed the images.Detection rates of 68Ga PSMA-PET/CT were evaluated,and impact on management was reviewed by comparison with CWU.Results:Median time to BCR post-RadP was 8.1 months.Detection rate for 68Ga PSMA-PET/CT was 80% (44/55).A positive scan was significantly associated with increasing prostate-specific antigen (PSA) level [odds ratio (OR) =1.13 (95% CI 1.05-1.30),P =0.017],but not with higher Gleason grade or shorter PSA doubling time.Compared to CWU,68Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan,resulting in a change in management in 25/44 (56.8%) patients:10 to hormonal therapy (HT) and whole pelvis radiotherapy (RT) in addition to bed RT,and 15 to palliative HT alone.Conclusions:In the present report,we demonstrated the diagnostic and treatment decision utility of 68Ga PSMA-PET/CT in Asian men with rapid BCR.Detection of small volume nodal and systemic recurrences at low PSA levels (< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease. OBJECTIVEProstate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk stratification tool for Asian men with rapid biochemical recurrence (BCR) following radical prostatectomy (RadP). This study aims to assess the detection rate of 68Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-RadP. METHODS68Ga PSMA-PET and CT body with/without bone scan [conventional workup (CWU)] were performed in 55 Asian patients with BCR within 36 months post-RadP. Two blinded reviewers assessed the images. Detection rates of 68Ga PSMA-PET/CT were evaluated, and impact on management was reviewed by comparison with CWU. RESULTSMedian time to BCR post-RadP was 8.1 months. Detection rate for 68Ga PSMA-PET/CT was 80% (44/55). A positive scan was significantly associated with increasing prostate-specific antigen (PSA) level [odds ratio (OR) = 1.13 (95% CI 1.05-1.30), P = 0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, 68Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44 (56.8%) patients: 10 to hormonal therapy (HT) and whole pelvis radiotherapy (RT) in addition to bed RT, and 15 to palliative HT alone. CONCLUSIONSIn the present report, we demonstrated the diagnostic and treatment decision utility of 68Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels (< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease. |
Author | Lam, Winnie W C Tong, Aaron K T Chua, Eu Tiong Lee, Lui Shiong Tan, Terence W K Goh, Charles X Y Wang, Michael L C Chua, Melvin L K Kanesvaran, Ravindran Toh, Chee Keong Koh, Yen Sin Tay, Kae Jack Li, Youquan Tuan, Jeffrey K L Tan, Janice S H |
AuthorAffiliation | Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610%Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore 169610;Radiological Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857%Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610;Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857%Department of Urology, Singapore General Hospital, Singapore 169610;Department of Surgery, Sengkang General Hospital, Singapore 544886%Department of Urology, Singapore General Hospital, Singapore 169610%Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857;Division of Medical Oncology, National Cancer Centre Singapore,Singapore 169610%Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610;Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857;Division of Medical Sciences, Nation |
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Author_xml | – sequence: 1 givenname: Janice S H surname: Tan fullname: Tan, Janice S H – sequence: 2 givenname: Charles X Y surname: Goh fullname: Goh, Charles X Y – sequence: 3 givenname: Yen Sin surname: Koh fullname: Koh, Yen Sin – sequence: 4 givenname: Youquan surname: Li fullname: Li, Youquan – sequence: 5 givenname: Jeffrey K L surname: Tuan fullname: Tuan, Jeffrey K L – sequence: 6 givenname: Eu Tiong surname: Chua fullname: Chua, Eu Tiong – sequence: 7 givenname: Terence W K surname: Tan fullname: Tan, Terence W K – sequence: 8 givenname: Michael L C surname: Wang fullname: Wang, Michael L C – sequence: 9 givenname: Lui Shiong surname: Lee fullname: Lee, Lui Shiong – sequence: 10 givenname: Kae Jack surname: Tay fullname: Tay, Kae Jack – sequence: 11 givenname: Ravindran surname: Kanesvaran fullname: Kanesvaran, Ravindran – sequence: 12 givenname: Chee Keong surname: Toh fullname: Toh, Chee Keong – sequence: 13 givenname: Aaron K T surname: Tong fullname: Tong, Aaron K T – sequence: 14 givenname: Winnie W C surname: Lam fullname: Lam, Winnie W C – sequence: 15 givenname: Melvin L K surname: Chua fullname: Chua, Melvin L K |
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Keywords | recurrence prostate cancer salvage radiotherapy prostatectomy diagnostic Asian 68Ga PSMA PET/CT |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work. |
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Publisher | Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610%Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore 169610 Department of Surgery, Sengkang General Hospital, Singapore 544886%Department of Urology, Singapore General Hospital, Singapore 169610%Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857 Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857%Department of Urology, Singapore General Hospital, Singapore 169610 Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857 Division of Medical Sciences, National Cancer Centre Singapore, Singapore 169610, Singapore Radiological Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857%Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610 Division of Medical Oncology, National Cancer Centre Singapore,Singapore 169610%Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610 Chinese Anti-Cancer Association China Anti-Cancer Association |
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Snippet | OBJECTIVEProstate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk stratification... Objective:Prostate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification... Objective Prostate cancers (PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts. There is no risk... |
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SubjectTerms | 68Ga PSMA PET/CT Asian diagnostic Original prostate cancer prostatectomy recurrence salvage radiotherapy |
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Title | 68Gallium-labelled PSMA-PET/CT as a diagnostic and clinical decision-making tool in Asian prostate cancer patients following prostatectomy |
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