Detection Rates of Recurrent Prostate Cancer: Gallium (Ga)-labelled Prostate-specific Membrane Antigen Choline PET/CT Scans. A Systematic Review

Overview

Journal Ther Adv Urol

Publisher Sage Publications

Date 2019 Jan 24

PMID 30671137

Citations 13

Authors

Masood Moghul

Bhaskar Somani

Tim Lane

Nikhil Vasdev

Brian Chaplin

Clive Peedell

Gokul Vignesh Kandaswamy

Bhavan Prasad Rai

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this work was to assess the use of prostate-specific membrane antigen (PSMA)-labelled radiotracers in detecting the recurrence of prostate cancer. PSMA is thought to have higher detection rates when utilized in positron emission tomography (PET)/computed tomography (CT) scans, particularly at lower prostate-specific antigen (PSA) levels, compared with choline-based scans.

Methods: A systematic review was conducted comparing choline and PSMA PET/CT scans in patients with recurrent prostate cancer following an initial curative attempt. The primary outcomes were overall detection rates, detection rates at low PSA thresholds, difference in detection rates and exclusive detection rates on a per-person analysis. Secondary outcome measures were total number of lesions, exclusive detection by each scan on a per-lesion basis and adverse side effects.

Results: Overall detection rates were 79.8% for PSMA and 66.7% for choline. There was a statistically significant difference in detection rates favouring PSMA [OR (M-H, random, 95% confidence interval (CI)) 2.27 (1.06, 4.85), = 0.04]. Direct comparison was limited to PSA < 2 ng/ml in two studies, with no statistically significant difference in detection rates between the scans [OR (M-H, random, 95% CI) 2.37 (0.61, 9.17) = 0.21]. The difference in detection on the per-patient analysis was significantly higher in the PSMA scans ( < 0.00001). All three studies reported higher lymph node, bone metastasis and locoregional recurrence rates in PSMA.

Conclusions: PSMA PET/CT has a better performance compared with choline PET/CT in detecting recurrent disease both on per-patient and per-lesion analysis and should be the imaging modality of choice while deciding on salvage and nonsystematic metastasis-directed therapy strategies.

Citing Articles

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Application of 18F-PSMA-1007 PET/MR Imaging in Early Biochemical Recurrence of Prostate Cancer: Results of a Prospective Study of 60 Patients with Very Low PSA Levels ≤ 0.5 ng/mL.

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Kim D, Lee W, Song Y, Hong S, Byun S, Kim J Prostate Int. 2023; 11(2):69-75.

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Incorporating PSMA-Targeting Theranostics Into Personalized Prostate Cancer Treatment: a Multidisciplinary Perspective.

Ng T, Gao X, Salari K, Zlatev D, Heidari P, Kamran S Front Oncol. 2021; 11:722277.

PMID: 34395293 PMC: 8355555. DOI: 10.3389/fonc.2021.722277.

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