title: Clinical impact of68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer with rising prostate-specific antigen after treatment with curative intent: preliminary analysis of a multidisciplinary approach.
abstract: To assess the impact of a novel molecular imaging technique,68Ga-(HBED-CC)-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT), in the clinical management of patients with prostate cancer with rising prostate-specific antigen (PSA) after treatment with curative intent.
  
  
  
  In all, 131 consecutive patients were referred to our centre for a68Ga-PSMA PET/CT in the setting of recurring prostate cancer. Of these patients, 11/131(8%) presented with persistent PSA after radical prostatectomy, while 120/131 (92%) were referred for biochemical recurrence after surgery, radiotherapy or both. The images where taken 1 h after injection of 2 MBq/kg of the68Ga-(HBED-CC)-PSMA ligand. All examinations were interpreted by two experienced nuclear medicine specialists. Using the results of the examination, a multidisciplinary oncology committee (MOC) reported on the treatment strategy. A positive impact on clinical management was considered if the examination determined a modification in the treatment strategy compared to the MOC decision before PSMA imaging.
  
  
  
  All patients completed the examination with no adverse reactions. The median (interquartile range) PSA level at the time of the examination was 2.2 (0.72-6.7) ng/mL. Overall,68Ga-PSMA PET/CT detected at least one lesion suspicious for prostate cancer in 98/131 (75%) patients. There was an impact on subsequent management in 99/131 patients (76%). The main modifications included continuing surveillance (withholding hormonal therapy), hormonal manipulations, stereotaxic radiotherapy, salvage radiotherapy, salvage node dissection or salvage local treatment (prostatectomy, high-intensity focussed ultrasound).
  
  
  
  Our preliminary experience suggests that performing68Ga-PSMA PET/CT in patients with prostate cancer with rising PSA after treatment with curative intent can be clinically useful as it changes the treatment strategy in a significant proportion of patients. However, larger prospective trials are needed to validate our present findings.
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Simone
authors.initials: S
authors.lastname: Albisinni
authors.affiliation: Department of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Carlos
authors.initials: C
authors.lastname: Artigas
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Fouad
authors.initials: F
authors.lastname: Aoun
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Biaou
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Julien
authors.initials: J
authors.lastname: Grosman
authors.affiliation: Department of Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Gil
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Hawaux
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Ksenija
authors.initials: K
authors.lastname: Limani
authors.affiliation: Department of Radiation Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Francois-Xavier
authors.initials: FX
authors.lastname: Otte
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Peltier
authors.affiliation: Department of Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Sideris
authors.affiliation: Department ofPathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sirtaine
authors.affiliation: Department of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Flamen
authors.affiliation: Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: van Velthoven
mesh_terms: D000368:Aged; D000066491:Clinical Decision-Making; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D005710:Gallium Radioisotopes; D017430:Prostate-Specific Antigen
keywords: #PCSM; #ProstateCancer; Diagnostics; PSMA; recurrence