Article Figures & Data
Figures
- FIGURE 1.
Overall rate of detection for 18F-PSMA-1007 PET/CT (A) and relative number of lesions grouped by different regions (B) in relation to PSA levels. LNM = lymph node metastases.
- FIGURE 2.
Images from 57-y-old patient after radical prostatectomy (2010; Gleason score of 8; pT3b; pN0), after salvage radiation therapy to prostate bed, and with PSA level rising to 0.43 ng/mL (August 2017). (A) Maximum-intensity projection of 18F-PSMA-1007 PET shows 2 intense tracer-associated lesions in left pelvic region (arrows). (B–D) Transaxial PET (C) and fused PET/CT (D) images show high 18F-PSMA-1007 uptake in subcentimeter (7-mm) lesions (arrows), as determined by corresponding CT (B). Subsequent radioguided salvage surgery proved malignant nature of lesions.
- FIGURE 3.
Images from 64-y-old patient after radical prostatectomy (August 2012; Gleason score of 9; pT3b; pN0) and with PSA level rising to 3.9 ng/mL (October 2017). (A) Maximum-intensity projection of 18F-PSMA-1007 PET shows intense tracer-associated uptake in lesion (arrow) below bladder. (C and D) It could be localized (arrows) in region of urethral anastomosis using transaxial PET (C) and fused PET/CT (D) images. (B) Corresponding CT image. Postimaging salvage radiation to prostatic fossa was performed in combination with single injection of gonadotropin-releasing hormone analog in October 2017 and resulted in drop in PSA level to below detection threshold (<0.07 ng/mL; last measurement in February 2018).
- FIGURE 4.
Images from 76-y-old patient after radical prostatectomy (2006; Gleason score of 7b; pT3a; pN0) and with PSA level slowly rising to 0.78 ng/mL (October 2017). (A and B) Patient underwent primarily 68Ga-PSMA-11 PET/CT, which resulted in suggestion of local recurrence (arrows). No definite diagnosis could be made on basis of adjacent high activity retention in urinary bladder. (C and D) Subsequent 18F-PSMA-1007 PET/CT 3 mo later clearly depicted PSMA ligand uptake in left seminal vesicle (arrows) with high contrast and very low retention in bladder.
- FIGURE 5.
Comparison of rates of detection for 18F-PSMA-1007 and 68Ga-PSMA-11 derived from different studies.
Tables
Characteristic No. of patients Range Percentage of patients Median age at PET/CT (y) 70 48–86 Further treatment External radiation after radical prostatectomy 110 43.8 Antihormonal treatment 74 29.5 ADT within 6 mo before imaging 60 23.9 Gleason score ≤6 13 5.2 7 125 49.8 ≥8 85 33.1 Unknown 28 11.2 Pathologic primary tumor staging (pT) pT2 74 29.5 pT3 92 36.7 pT4 7 2.8 Unknown 78 31.1 Pathologic regional lymph node staging (pN) pN0 123 49.0 pN1 41 16.3 pNx 87 34.7 Positive margin R0 80 31.8 R1 53 21.1 Unknown 118 47.0 Median initial PSA level (ng/mL) 10.9 0.6–250 Salvage radiation therapy before PET/CT 110 43.8 Median time between surgery and PET/CT (mo) 57 1–321 Median last PSA level before PET/CT (ng/mL) 1.2 0.2–228 - TABLE 2
18F-PSMA-1007 PET/CT Detection of Different Regions Involved by Recurrent Prostate Cancer
Region No. of patients Percentage of patients Local recurrence 62 24.7 Lymph node metastases Pelvic 102 40.6 Retroperitoneal 49 19.5 Supradiaphragmatic 30 12.0 Bone metastases 101 40.2 Other (lung, liver) metastases 9 3.6 More than 1 region could be involved per patient.
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