PT  - JOURNAL ARTICLE
AU  - Kranzbühler, Benedikt
AU  - Müller, Julian
AU  - Becker, Anton S.
AU  - Garcia Schüler, Helena I.
AU  - Muehlematter, Urs
AU  - Fankhauser, Christian D.
AU  - Kedzia, Sarah
AU  - Guckenberger, Matthias
AU  - Kaufmann, Philipp A.
AU  - Eberli, Daniel
AU  - Burger, Irene A.
TI  - Detection Rate and Localization of Prostate Cancer Recurrence Using <sup>68</sup>Ga-PSMA-11 PET/MRI in Patients with Low PSA Values ≤ 0.5 ng/mL
AID  - 10.2967/jnumed.118.225276
DP  - 2020 Feb 01
TA  - Journal of Nuclear Medicine
PG  - 194--201
VI  - 61
IP  - 2
4099  - http://jnm.snmjournals.org/content/61/2/194.short
4100  - http://jnm.snmjournals.org/content/61/2/194.full
SO  - J Nucl Med2020 Feb 01; 61
AB  - A first analysis of simultaneous 68Ga-prostate-specific membrane antigen (PSMA)-11 PET/MRI showed some improvement in the detection of recurrent disease at low serum prostate specific antigen (PSA) values below 0.5 ng/mL compared with the already high detection rate of 68Ga-PSMA-11 PET/CT. We therefore focused on all patients with biochemical recurrence and PSA values no higher than 0.5 ng/mL to assess the detection rate for 68Ga-PSMA-11 PET/MRI. Methods: We retrospectively analyzed a cohort of 66 consecutive patients who underwent 68Ga-PSMA-11 PET/MRI for biochemical recurrence with a PSA value no higher than 0.5 ng/mL at our institution. Median PSA level was 0.23 ng/mL (range, 0.03–0.5 ng/mL). Detection of PSMA-positive lesions within the prostate fossa, local and distant lymph nodes, bones, or visceral organs was recorded. In addition, all scans with 68Ga-PSMA-11 PET/MRI–positive lesions were retrospectively assessed to analyze if lesions were detected inside or outside a standard salvage radiotherapy volume. Results: Overall, in 36 of 66 patients (54.5%) PSMA-positive lesions were detected; in 26 of 40 (65%) patients with a PSA level between 0.2 and 0.5 ng/mL and in 10 of 26 (38.5%) patients with a PSA level less than 0.2 ng/mL. Even at those low PSA values, only 8 of 66 (12.1%) patients had exclusive local recurrence. Lymph nodes were detected in 23 patients and bone metastases in 5 on 68Ga-PSMA-11 PET/MRI. In 26 of 66 patients (39.4%), PSMA-positive lesions were located outside a standard salvage radiotherapy volume. Conclusion: Our data confirm that 68Ga-PSMA-11 PET/MRI has a high detection rate for recurrent prostate cancer, even at low PSA levels no higher than 0.5 ng/mL. In addition, we show that 68Ga-PSMA-11 PET/MRI detected PSMA-positive lesions outside a standard salvage radiotherapy volume in 39.4% of all patients.