<sup>68</sup>Ga-PSMA PET/CT versus CT and bone scan for investigation of PSA failure post radical prostatectomy

doi:10.1016/j.ajur.2020.02.001

Asian Journal of Urology, 2021, 8 (2): 170-175 doi: 10.1016/j.ajur.2020.02.001

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⁶⁸Ga-PSMA PET/CT versus CT and bone scan for investigation of PSA failure post radical prostatectomy

Yuigi Yuminaga^a,*(

),Chris Rothe^b,Jonathan Kam^a,Kieran Beattie^a,Mohan Arianayagam^a,Chuong Bui^b,Bertram Canagasingham^a,Richard Ferguson^a,Mohamed Khadra^a,Raymond Ko^a,Ken Le^b,Diep Nguyen^b,Celi Varol^a,Matthew Winter^a

^a Nepean Urology Research Group, Nepean Hospital, Penrith New South Wales, Australia
^b Nepean Radiology Research Group, Nepean Hospital, Penrith New South Wales, Australia

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Abstract

Objective To evaluate the use of Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga-PSMA PET/CT), compared with conventional CT abdomen/pelvis (CTAP) and whole body single photon emission CT bone scan (BS), for detection of local or distant metastasis following biochemical failure/recurrence in post-prostatectomy patients.
Methods We conducted a review of our prospectively maintained, institutional database to identify 384 patients with post-prostatectomy biochemical failure/recurrence who underwent PSMA PET/CT, CTAP and BS from February 2015 to August 2017 in Nepean Hospital, tertiary referral centre. The results of the three imaging modalities were analysed for their ability to detect local recurrence and distant metastases. PSMA PET/CT and CTAP imaging were separately performed on the same day and the BS was performed within several days (mostly in 24 h). Difference in detection rates was determined between the modalities and the Chi square test was used to determine significance.
Results A total of 384 patients were identified with a median prostate-specific antigen (PSA) of 0.465 ng/mL (interquartile range =0.19-2.00 ng/mL). Overall, PSMA PET/CT was positive for 245 (63.8%) patients whereas CTAP and BS were positive in 174 patients (45.3%). A total of 98 patients (25.5%) had local or distant metastasis detected on PSMA only, while 20 patients (5.2%) had recurrences detected on CTAP but not on PSMA PET/CT.
Conclusion The use of PSMA PET/CT has a higher detection rate of predicted local or distant metastasis compared to CTAP and BS in the staging of patients with biochemical recurrences after radical prostatectomy.

Key words： Prostatic neoplasms Positron-emission tomography Prostate-specific antigen Neoplasm staging Bone scan

Received: 10 April 2019 Available online: 10 February 2020

Corresponding Authors: Yuigi Yuminaga E-mail: yuigiyuminaga@gmail.com

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	Yuigi Yuminaga
	Chris Rothe
	Jonathan Kam
	Kieran Beattie
	Mohan Arianayagam
	Chuong Bui
	Bertram Canagasingham
	Richard Ferguson
	Mohamed Khadra
	Raymond Ko
	Ken Le
	Diep Nguyen
	Celi Varol
	Matthew Winter

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Cite this article:

Yuigi Yuminaga,Chris Rothe,Jonathan Kam, et al. ⁶⁸Ga-PSMA PET/CT versus CT and bone scan for investigation of PSA failure post radical prostatectomy[J]. Asian Journal of Urology, 2021, 8(2): 170-175.

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http://www.ajurology.com/EN/10.1016/j.ajur.2020.02.001 OR http://www.ajurology.com/EN/Y2021/V8/I2/170

Patient demographics, postprostatectomy PSA and Gleason score.

PMSA PET/CT scan versus CT abdomen pelvis and BS.

PMSA PET/CT Scan versus CT abdomen pelvis and bone scan in finding oligometastatic disease.

Detection rates of PSMA PET following radical prostatectomy based on PSA banding.

Regions of detection PSMA PET following radical prostatectomy based on PSA banding.

The results of PET/CT and CT scan. Both PSMA PET/CT scan (A) and CT abdomen and pelvis (B) showed positive right pelvic lymph nodes; Both PSMA PET/CT scan (C) and bone scan (D) showed positive lesion on vertebral body. CT, computed tomography; PET/CT, positron emission tomography/computed tomography; PSMA, prostatespecific membrane antigen.

The results of CT and PET/CT scan. (A) CT scan showing a possible lesion in the previous prostatectomy site; (B) PSMA PET/CT scan showing avid lesion at prostatic bed. CT, computed tomography; PET/CT, positron emission tomography/computed tomography; PSMA, prostatespecific membrane antigen.

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