• BJU international · Jul 2019

    Gallium-68-prostate-specific membrane antigen (68 Ga-PSMA) positron emission tomography (PET)/computed tomography (CT) predicts complete biochemical response from radical prostatectomy and lymph node dissection in intermediate- and high-risk prostate cancer.

    • Pim J van Leeuwen, Maarten Donswijk, Rohan Nandurkar, Phillip Stricker, Bao Ho, Stijn Heijmink, Esther M K Wit, Corinne Tillier, Erik van Muilenkom, Quoc Nguyen, Henk G van der Poel, and Louise Emmett.
    • Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
    • BJU Int. 2019 Jul 1; 124 (1): 62-68.

    ObjectiveTo determine the value of gallium-68-prostate-specific membrane antigen (68 Ga-PSMA)-11 positron emission tomography (PET) /computed tomography (CT) in men with newly diagnosed prostate cancer.Patients And MethodsWe analysed results of 140 men with intermediate- and high-risk prostate cancer. All men underwent 68 Ga-PSMA-11 PET/CT and multiparametric magnetic resonance imaging (mpMRI) before radical prostatectomy (RP) with extended pelvic lymph node (LN) dissection. For each patient, the clinical and pathological features were recorded. Prostate-specific antigen (PSA) was documented at staging scan, and after RP, at a median (interquartile range) of 110 (49-132) days. A PSA level of ≥0.03 ng/mL was classified as biochemical persistence (BCP). Logistic regression was performed for association of clinical variables and BCP.ResultsIn these 140 patients with intermediate- and high-risk prostate cancer, 27.1% had PSMA PET/CT-positive findings in the pelvic LNs. Sensitivity and specificity for detection of LN metastases were 53% and 88% (PSMA PET/CT) and 14% and 99% (mpMRI), respectively. The overall BCP rate was 25.7%. The BCP rate was 16.7% in men who were PSMA PET/CT LN-negative compared to 50% in men who were PSMA PET/CT LN-positive (P < 0.05). The presence of PSMA-positive pelvic LNs was more predictive of BCP after RP than cT-stage, PSA level, and the Gleason score, adjusted for surgical margins status.Conclusions68 Ga-PSMA-11 PET/CT is highly predictive of BCP after RP, and should play an important role informing men with intermediate- or high-risk prostate cancer.© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

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