RT Journal Article
SR Electronic
T1 Identification of PCWG3 Target Populations Is More Accurate and Reproducible with PSMA PET Than with Conventional Imaging: A Multicenter Retrospective Study
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 675
OP 678
DO 10.2967/jnumed.120.246603
VO 62
IS 5
A1 Farolfi, Andrea
A1 Hirmas, Nader
A1 Gafita, Andrei
A1 Weber, Manuel
A1 Barbato, Francesco
A1 Wetter, Axel
A1 Mei, Riccardo
A1 Pianori, Davide
A1 Hadaschik, Boris
A1 Herrmann, Ken
A1 Castellucci, Paolo
A1 Fanti, Stefano
A1 Eiber, Matthias
A1 Fendler, Wolfgang P.
YR 2021
UL http://jnm.snmjournals.org/content/62/5/675.abstract
AB Prostate-specific membrane antigen (PSMA)–ligand PET is potentially useful for screening of castration-resistant prostate cancer (CRPC) clinical trial target populations. We investigated the impact of PSMA PET on Prostate Cancer Clinical Trials Working Group 3 (PCWG3) clinical subtype classification when compared with conventional imaging (CI). Methods: A multicenter retrospective study enrolled patients who had undergone PSMA PET for CRPC, had prostate-specific antigen values of at least 1 ng/mL, and had undergone CI—that is, CT plus bone scanning or whole-body MRI. The clinical PCWG3 subtype was determined for PET versus CI by 3 masked readers. Results: Sixty-seven patients were included, and PSMA PET led to up-staging in 15% (10/67) of patients; of these, 6 of 10 (60%) had nonmetastatic CRPC on CI. PSMA PET resulted in down-staging in 15% (10/67) of patients. Agreement for PET versus CI PCWG3 clinical subtypes was 0.81 versus 0.51, 0.74 versus 0.47, 0.95 versus 0.72, or 0.59 versus 0.66 for local, nodal, bone, or visceral disease, respectively. Conclusion: Despite 70% concordance with CI, PSMA PET demonstrated superior reproducibility and accuracy especially for non-metastatic CRPC and should be implemented in future clinical trial entry procedures.