title: [PSMA-radioguided surgery in localized recurrent prostate cancer : Current and future aspects].
abstract: Recently, PSMA-radioguided surgery (PSMA-RGS) was introduced for targeted resection of localized prostate cancer recurrence. Prerequisite for preoperative patient selection and localization of tumor recurrence is a positive68Ga-HBED-CC PSMA positron emission tomography (PET) scan with preferably only singular soft tissue or lymph node recurrence. After injection of In-PSMA I&T or Tc-PSMA-I&S single photon emission computer tomography (SPECT)/computer tomography (CT) examination is performed in every patient to verify radiotracer uptake in tumor lesions. In a preliminary study,111In-PSMA I&T SPECT/CT could detect about half of the68Ga-HBED-CC PSMA PET-positive lesions, while nearly all PET-positive lesions could be detected using PSMA-RGS and also five additional lesions compared to68Ga-HBED-CC-PSMA PET. Follow-up data from 55 patients show a PSA reduction >50% and >90% in 44 (80%) and 29 (53%) patients, respectively. In 34 (62%) patients, a PSA drop to <0.2 ng/ml was observed. In all, 15 (27%) patients received further PC-specific treatment; the remaining 40 (73%) patients did not undergo further treatment. In 33% of patients, surgery-related complications were noted; however, most were regarded as minor. Thus, PSMA-RGS seems to be of high value in patients with localized prostate cancer recurrence with exact localization and resection of metastatic tissue. However, patient selection based on68Ga-PSMA PET imaging and clinical parameters is crucial to obtain satisfactory oncological results.
authors.affiliation: Klinikum rechts der Isar, Nuklearmedizinische Klinik und Poliklinik, Technische Universität München, München, Deutschland.
authors.forename: I
authors.initials: I
authors.lastname: Rauscher
authors.affiliation: Klinikum rechts der Isar, Nuklearmedizinische Klinik und Poliklinik, Technische Universität München, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Eiber
authors.affiliation: Urologische Klinik, Universitätsklinikum Freiburg, Freiburg, Deutschland.
authors.forename: C A
authors.initials: CA
authors.lastname: Jilg
authors.affiliation: Klinikum rechts der Isar, Urologische Klinik und Poliklinik, Technische Universität München, Ismaninger Str. 22, 81671, München, Deutschland.
authors.forename: J E
authors.initials: JE
authors.lastname: Gschwend
authors.affiliation: Klinikum rechts der Isar, Urologische Klinik und Poliklinik, Technische Universität München, Ismaninger Str. 22, 81671, München, Deutschland. tobias.maurer@tum.de.
authors.forename: T
authors.initials: T
authors.lastname: Maurer
mesh_terms: D004492:Edetic Acid / Q000031:analogs & derivatives; D019317:Evidence-Based Medicine; D005544:Forecasting; D005709:Gallium Isotopes; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D009842:Oligopeptides; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000639:trends*; D011468:Prostatectomy / Q000379:methods / Q000639:trends*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D005709:Gallium Isotopes; D005710:Gallium Radioisotopes; D009842:Oligopeptides; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C000718244:gallium 68 PSMA-11; D004492:Edetic Acid
keywords: Gamma probe measurements; Membrane antigen, prostate specific; Positron emission tomography; Salvage surgery; Tumor recurrence