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Research ArticleTheranostics

PSMA-Ligand PET for Early Castration-Resistant Prostate Cancer: A Retrospective Single-Center Study

Manuel Weber, Claudia Kurek, Francesco Barbato, Matthias Eiber, Tobias Maurer, Michael Nader, Boris Hadaschik, Viktor Grünwald, Ken Herrmann, Axel Wetter and Wolfgang P. Fendler
Journal of Nuclear Medicine January 2021, 62 (1) 88-91; DOI: https://doi.org/10.2967/jnumed.120.245456
Manuel Weber
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Claudia Kurek
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Francesco Barbato
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Matthias Eiber
2Department of Nuclear Medicine, Technical University Munich, Munich, Germany
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Tobias Maurer
3Department of Urology and Martini-Klinik, University of Hamburg–Eppendorf, Hamburg, Germany
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Michael Nader
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Boris Hadaschik
4Department of Urology, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Viktor Grünwald
5Interdisciplinary Genitourinary Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; and
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Ken Herrmann
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Axel Wetter
6Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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Wolfgang P. Fendler
1Department of Nuclear Medicine, University of Duisburg–Essen, and German Cancer Consortium–University Hospital Essen, Essen, Germany
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    FIGURE 1.

    Proportion of local (Tr), nodal (N1), or distant (M1) disease (A) and N/M disease extent (B) stratified by PSA range for presented patients, including previous data by Fendler et al. (6). Six patients in study of Fendler et al. were excluded because of PSA ≥ 8 wk before PET. multi = multiple or disseminated; oligo = oligometastatic; uni = unifocal. *n = 9 overlap. †n = 5 overlap.

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    TABLE 1

    Disease Extent Stratified by PSA at Time of Imaging According to PROMISE (n = 55) (17)

    PSMA PET/CT findingsTotal (n = 55)Pre-PCWG3 PSA: <1.0 ng/mL (n = 21)Early PCWG3 PSA: 1.0–<2.0 ng/mL (n = 11)Early EAU PSA: 2.0–≤ 3.0 ng/mL (n = 23)
    Negative14 (25)10 (48)0 (0)4 (17)
    Tr/N1 only16 (29)6 (29)3 (27)7 (30)
     Local recurrence (Tr)9 (16)3 (14)1 (9)5 (22)
     Pelvic lymph nodes (N1)9 (16)3 (14)2 (18)4 (17)
    Any M125 (45)5 (24)8 (73)12 (52)
     Extrapelvic lymph nodes (M1a)15 (27)3 (14)3 (27)9 (39)
     Bone (M1b)13 (24)3 (14)4 (36)6 (26)
     Soft tissue/visceral (M1c)2 (4)0 (0)2 (18)0 (0)
    N/M disease extent34 (62)8 (38)0 (0)16 (70)
     Unifocal (1)6 (18)2 (25)1 (10)3 (19)
     Oligometastatic (2–5)17 (50)4 (50)9 (90)4 (25)
     Multiple or disseminated (≥6)11 (32)2 (25)0 (0)9 (56)
    • Data are number of patients, followed by percentage in parentheses.

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    TABLE 2

    Regression Analysis of Clinical Parameters and Their Respective Risk for PSMA PET/CT Detection (n = 55)

    VariablenOdds ratio for PET-positivePOdds ratio for PET M1P
    Age ≥ 6540 of 55 (73)1.3 (0.3–4.9)0.750.9 (0.3–3.1)0.91
    Gleason score ≥ 828 of 47 (60)1.3 (0.2–5.1)0.701.2 (0.4–3.9)0.77
    PSA ≥ 1.5 ng/mL28 of 55 (51)3.0 (0.8–11.3)0.112.0 (0.7–5.8)0.22
    PSA doubling time ≤ 6 mo27 of 44 (61)0.8 (0.2–3.5)0.821.3 (0.4–4.2)0.70
    Locoregional disease pT3/pT4*20 of 31 (65)1.5 (0.2–9.4)0.601.2 (0.3–5.2)0.81
    Locoregional disease pN1†12 of 30 (40)1.4 (0.2–9.4)0.710.6 (0.1–2.5)0.46
    Primary radiation therapy11 of 55 (20)0.5 (0.1–2.1)0.360.1 (0.0–0.7)0.02*
    • ↵* Analyzed for all patients after prostatectomy with known pT stage.

    • ↵† Analyzed for all patients after lymphadenectomy with known pN stage.

    • Data in parentheses are percentage or 95% confidence interval.

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Journal of Nuclear Medicine: 62 (1)
Journal of Nuclear Medicine
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PSMA-Ligand PET for Early Castration-Resistant Prostate Cancer: A Retrospective Single-Center Study
Manuel Weber, Claudia Kurek, Francesco Barbato, Matthias Eiber, Tobias Maurer, Michael Nader, Boris Hadaschik, Viktor Grünwald, Ken Herrmann, Axel Wetter, Wolfgang P. Fendler
Journal of Nuclear Medicine Jan 2021, 62 (1) 88-91; DOI: 10.2967/jnumed.120.245456

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PSMA-Ligand PET for Early Castration-Resistant Prostate Cancer: A Retrospective Single-Center Study
Manuel Weber, Claudia Kurek, Francesco Barbato, Matthias Eiber, Tobias Maurer, Michael Nader, Boris Hadaschik, Viktor Grünwald, Ken Herrmann, Axel Wetter, Wolfgang P. Fendler
Journal of Nuclear Medicine Jan 2021, 62 (1) 88-91; DOI: 10.2967/jnumed.120.245456
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Keywords

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