Article Figures & Data
Figures
- FIGURE 1.
Percentage of patients with disease detected on 68Ga-PSMA-11 PET categorized by PSA level at time of imaging. Numbers in brackets are patients in each group with PET findings positive for disease. Percentage is percentage of patients in each group positive for disease.
- FIGURE 2.
Distribution of sites of disease seen on 68Ga-PSMA-11 PET as percentage of total patients. The most common sites of disease were prostate bed and pelvic lymph nodes (LN). RP = extrapelvic retroperitoneal.
- FIGURE 3.
Change in clinician’s description of disease location before and after imaging. Percentage of patients for whom clinicians did not know disease location decreased from 52% to 20%. ST = soft tissues.
- FIGURE 4.
Example of major change in management. A 69-y-old man with biochemically recurrent prostate cancer was originally treated with RP in 2014 and then with salvage RT in 2015. He presented for 68Ga-PSMA-11 PET with PSA of 0.059. Imaging demonstrated single PSMA-positive lesion in right iliac bone (C), with no correlate seen on CT (A and [fused image] B). Management was converted from active surveillance to RT combined with androgen-deprivation therapy.
Tables
Characteristic Data Age (y) 69.0 ± 6.9 Imaging modality PET/CT 63 (50) PET/MRI 63 (50) Prior treatment RP 43 (34) RT 41 (33) Both RP and RT 33 (26) Other treatments 9 (7) ADT 41 (32) Currently on ADT 8 (6) Time since last treatment (y) 5.3 ± 5.4 Prior conventional imaging CT of abdomen or pelvis 57 (45) Bone scanning or 18F-NaF PET 55 (44) MRI of pelvis 22 (17) Any prior imaging 80 (73) Laboratory values PSA (ng/dL) 5.9 ± 10.3 PSA doubling time (mo) 8.7 ± 11.0 Gleason score at diagnosis* 3 + 3 19 (16) 3 + 4 27 (22) 4 + 3 34 (28) 4 + 4 17 (14) 4 + 5 17 (14) 5 + 4 4 (3) 5 + 5 3 (2) ↵* Five patients did not have Gleason score at initial biopsy available.
ADT = androgen-deprivation therapy.
Qualitative data are expressed as numbers followed by percentages in parentheses; continuous data are expressed as mean ± SD.
- TABLE 2
Imaging Studies That Would Have Been Ordered in Place of 68Ga-PSMA-11 PET on Preimaging Surveys, and Studies That Were Prevented from Being Ordered on Postimaging Surveys
Imaging study Would have been ordered Prevented from being ordered Bone scanning 70 (56%) 21 (17%) CT 44 (35) 17 (13) MRI 36 (29) 3 (2) PET (18F-FDG or choline) 16 (13) 13 (10) Image-guided biopsy 5 (4) 8 (6) ProstaScint 1 (1) 0 (0) Treatment change n % Major changes 67 53.2 Conversion to targeted treatment 40 31.7 ADT > RT 12 9.5 AS > RT 10 7.9 ADT > RT+ADT 6 4.8 AS > RT+ADT 5 4.0 Biopsy > RT 2 1.6 Biopsy > RT+ADT 2 1.6 Biopsy > cryoablation 1 0.8 RT+ADT > surgery 1 0.8 Sipuleucel-T > RT 1 0.8 Conversion to systemic treatment 12 9.5 AS > ADT 5 4.0 RT+ADT > ADT monotherapy 2 1.6 RT > ADT 2 1.6 AS > abiraterone 1 0.8 Surgery > ADT 1 0.8 Biopsy > ADT 1 0.8 Conversion to AS 10 7.9 RT+ADT > AS 4 3.2 ADT > AS 4 3.2 RT > AS 2 1.6 Miscellaneous 5 4.0 Surgery > RT+ADT 2 1.6 RT+ADT > cryoablation 1 0.8 RT+ADT > RT+ADT+chemotherapy 1 0.8 ADT > PSMA RLT 1 0.8 Minor changes 8 6.4 RT > RT+ADT 5 4.0 RT+ADT > RT 3 2.4 ADT = androgen-deprivation therapy; AS = active surveillance; RLT = radioligand therapy.
- TABLE 4
Patients with Major Changes in Management Categorized by Prior Treatment and PSA Level
Prior treatment Parameter RP RT RP and RT Total patients (n) 43 41 33 Mean PSA ± SD (ng/dL) 2.7 ± 4.0 9.9 ± 14.6 3.9 ± 6.9 Major change (n) 14 (33%) 24 (59%) 23 (70%) Number with RT as treatment option on preimaging survey (n) 26 (61%) 10 (24%) 5 (15%) PSA < 2 ng/dL Patients (n) 29 9 20 Major change (n) 9 (31%) 6 (67%) 14 (70%) PSA > 2 ng/dL Patients (n) 14 32 13 Major change (n) 5 (36%) 18 (56%) 9 (69%)
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