Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer

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Abstract

In retrospective studies, 68Ga-PSMA-11 positron emission tomographic (PET) imaging improves detection of biochemically recurrent prostate cancer compared with conventional imaging.

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Most cited references 16

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Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference.

Mack Roach, Gerald Hanks, Howard Thames … (2006)

In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined "at call" (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to "adequate follow-up." To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature.

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Impact of 68 Ga-PSMA PET on the Management of Patients with Prostate Cancer: A Systematic Review and Meta-analysis

Sangwon Han, Yeon Kim, Chong Suh … (2018)

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Pearls and pitfalls in clinical interpretation of prostate-specific membrane antigen (PSMA)-targeted PET imaging.

Ali Afshar-Oromieh, Sara Sheikhbahaei, Kenneth Pienta … (2017)

The rapidly expanding clinical adaptation of prostate-specific membrane antigen (PSMA)-targeted PET imaging in the evaluation of patients with prostate cancer has placed an increasing onus on understanding both the potential pearls of interpretation as well as limitations of this new technique. As with any new molecular imaging modality, accurate characterization of abnormalities on PSMA-targeted PET imaging can be accomplished only if one is aware of the normal distribution pattern, physiological variants of radiotracer uptake, and potential sources of false-positive and false-negative imaging findings. In recent years, a growing number of reports have come to light describing incidental non-prostatic benign or malignant pathologies with high uptake on PSMA-targeted PET imaging. In this review, we have summarized the published literature regarding the potential pearls and technical and interpretive pitfalls of this imaging modality. Knowledge of these limitations can increase the confidence of interpreting physicians and thus improve patient care.

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Author and article information

Journal

Title: JAMA Oncology

Abbreviated Title: JAMA Oncol

Publisher: American Medical Association (AMA)

ISSN (Print): 2374-2437

Publication date (Electronic): March 28 2019

Affiliations

[1 ]Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles

[2 ]Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

[3 ]Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

[4 ]Departments of Radiology and Biomedical Imaging and Pharmaceutical Chemistry, University of California San Francisco, San Francisco

[5 ]Department of Urology, University of California San Francisco, San Francisco

[6 ]Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco

[7 ]Department of Urology, UCLA Medical Center, University of California Los Angeles, Los Angeles

[8 ]Division of Hematology/Oncology, Department of Medicine, University of California Los Angeles, Los Angeles

[9 ]Division of Hematology/Oncology, Department of Medicine, VA Greater Los Angeles, Los Angeles, California

[10 ]Department of Radiology, Obihiro Kosei Hospital, Obihiro, Japan

[11 ]Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

[12 ]Department of Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia

[13 ]Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark

[14 ]Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Munich, Germany

[15 ]Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany

[16 ]Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York

[17 ]Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland

[18 ]Division of Hematology/Oncology, Department of Medicine, University of California San Francisco

Article

DOI: 10.1001/jamaoncol.2019.0096

PMC ID: 6567829

PubMed ID: 30920593

SO-VID: 13e9415d-668f-4208-9d70-ad2d9670e6ce

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