Abstract
241709
Introduction: PSMA PET has superior sensitivity and specificity compared to conventional imaging modalities, suggesting PSMA PET should be considered as the primary modality for prostate cancer staging. However, conventional short field-of-view PET encounters challenge when endeavoring to encompass the total-body due to patient discomfort and the demands of bustling clinical workflows. Total-body 68Ga-PSMA-11 PET/CT provides sufficient image quality to meet diagnostic needs within a mere 5-minute scan duration. To the best of our knowledge, no prior investigations have harnessed total-body 68Ga-PSMA-11 PET/CT for the detection of lesions situated beyond the purview of conventional PET/CT scans. This study aimed to evaluate the efficacy of total-body 68Ga-PSMA-11 PET/CT in the detection of lesions outside of the conventional field of view in prostate cancer, and to assess its influence on patient management.
Methods: A cohort comprising 886 prostate cancer patients underwent total-body 68Ga-PSMA-11 PET/CT scans from May 2020 to March 2023. The study conducted an analysis to establish the correlation between the detection of bone lesions, particularly those situated beyond the customary scanning range, and clinical indications, Gleason scores, and PSA values. Furthermore, the study investigated the impact of total-body 68Ga-PSMA-11 PET/CT on prostate cancer staging and its consequent effect on treatment decisions.
Results: Among the 886 patients, 37.70% (334 patients) were found to have bone metastases, and 8.47% (75 patients) were found to have bone metastases beyond the standard scan range. Notably, patients in more advanced disease stages, those with higher Gleason scores, and those presenting elevated PSA values demonstrated an elevated likelihood of harboring bone metastases beyond the standard scanning range. Within the subset of 75 patients featuring extra-range bone metastases, 9 individuals underwent reclassification of their clinical staging, and 22 experienced alterations in their treatment plans as a direct consequence of the identification of bone lesions situated beyond the customary scanning range.
Conclusions: This study emphasizes the value of total-body 68Ga-PSMA-11 PET/CT in detecting prostate cancer bone metastases beyond the standard scan range. Among 886 patients, 8.47% had extra-range metastases, especially in advanced disease stages. Total-body PET/CT 68Ga-PSMA-11 led to reclassification and altered treatment plans, improving staging and management. Unlike conventional PET, it offers faster, feasible whole-body scanning without added patient burden. In summary, total-body 68Ga-PSMA-11 PET/CT is beneficial for prostate cancer patients by detecting critical beyond-range lesions and enhancing diagnostic capabilities.
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