PMID- 30890448
OWN - NLM
STAT- In-Data-Review
LR  - 20190617
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 104
IP  - 4
DP  - 2019 Jul 15
TI  - A Multicenter Prospective Clinical Trial of (68)Gallium PSMA HBED-CC PET-CT
      Restaging in Biochemically Relapsed Prostate Carcinoma: Oligometastatic Rate and 
      Distribution Compared With Standard Imaging.
PG  - 801-808
LID - S0360-3016(19)30370-0 [pii]
LID - 10.1016/j.ijrobp.2019.03.014 [doi]
AB  - PURPOSE: The purpose of this study is to assess the utility of (68)Gallium
      prostate-specific membrane antigen (PSMA) Division of Radiopharmaceutical
      Chemistry (DKFZ)-PSMA-11 positron emission tomography (PET)-computed tomography
      (CT), compared with standard imaging, in the detection of recurrent prostate
      carcinoma in patients with biochemical relapse to determine the prevalence of
      oligometastatic disease recurrence and its distribution. METHODS AND MATERIALS:
      This is a prospective, multicenter clinical trial of PSMA-HBED PET/CT imaging in 
      patients with early biochemical relapse of prostate carcinoma (median
      prostate-specific antigen [PSA], 2.55 ng/mL) after definitive prostatectomy (152 
      patients) or radiation therapy (86 patients) with either no lesions or
      oligometastatic disease on abdominopelvic CT and bone scan (BS). PSMA-HBED PET/CT
      scan was performed within 8 weeks of restaging imaging, and all sites of abnormal
      PSMA-HBED binding determined as probable or definite for prostate carcinoma were 
      included in the analysis. PSMA positivity was assessed for correlation with
      Gleason Score, PSA level, and PSA doubling time. RESULTS: Two hundred
      thirty-eight patients underwent PSMA-HBED PET/CT imaging. In 199 patients with no
      lesions on restaging CT and BS, 148 patients (74%) demonstrated PSMA-positive
      lesions, with 113 patients (57%) being oligometastatic. In 39 patients with
      oligometastatic lesions on restaging CT and BS, 19 patients (49%) were confirmed 
      as oligometastatic on PSMA PET/CT and 16 patients (41%) were upstaged to
      polymetastatic. The 4 remaining patients (10%) with sites of possible metastatic 
      disease were not confirmed as having prostate carcinoma. Combining the overall
      group, there were 183 patients (77%) with PSMA-HBED-positive lesions (682
      lesions), suggesting prostate carcinoma, of whom 132 patients (55%) were
      oligometastatic. In the oligometastatic group, PSMA positivity was limited to the
      pelvis in 65% of patients, involving either the prostate or nodes (American Joint
      Committee on Cancer stage N1). This study found a positive correlation between
      PSMA-HBED positivity and PSA levels; no other factors were statistically
      significant. CONCLUSIONS: For patients with biochemical relapse with BS and CT
      demonstrating either no disease or low-volume disease, there is a high overall
      prevalence of PSMA PET/CT-positive disease. More than half of the patients were
      oligometastatic, and of those, disease was confined to the pelvis in nearly
      two-thirds of patients. This result confirms that PSMA PET/CT is significantly
      more sensitive than standard restaging imaging, and it may be useful in
      identifying patients for subsequent targeted therapy.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - McCarthy, Michael
AU  - McCarthy M
AD  - Department of Nuclear Medicine and PET, Sir Charles Gairdner Hospital, Perth,
      Australia; Molecular Imaging and Therapy Service (Nuclear Medicine), Royal Perth 
      Hospital and Fiona Stanley Hospital, Perth, Australia. Electronic address:
      Michael.McCarthy@health.wa.gov.au.
FAU - Francis, Roslyn
AU  - Francis R
AD  - Department of Nuclear Medicine and PET, Sir Charles Gairdner Hospital, Perth,
      Australia; Medical School, Faculty of Health and Medical Sciences, Harry Perkins 
      Institute of Medical Research, Perth, Australia.
FAU - Tang, Colin
AU  - Tang C
AD  - Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth,
      Australia.
FAU - Watts, Joanne
AU  - Watts J
AD  - Department of Nuclear Medicine and PET, Sir Charles Gairdner Hospital, Perth,
      Australia.
FAU - Campbell, Andrew
AU  - Campbell A
AD  - Molecular Imaging and Therapy Service (Nuclear Medicine), Royal Perth Hospital
      and Fiona Stanley Hospital, Perth, Australia; Medical Engineering and Physics,
      Royal Perth Hospital and Fiona Stanley Hospital, Perth, Australia.
LA  - eng
PT  - Journal Article
DEP - 20190316
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
EDAT- 2019/03/21 06:00
MHDA- 2019/03/21 06:00
CRDT- 2019/03/21 06:00
PHST- 2018/03/28 00:00 [received]
PHST- 2019/02/19 00:00 [revised]
PHST- 2019/03/11 00:00 [accepted]
PHST- 2019/03/21 06:00 [pubmed]
PHST- 2019/03/21 06:00 [medline]
PHST- 2019/03/21 06:00 [entrez]
AID - S0360-3016(19)30370-0 [pii]
AID - 10.1016/j.ijrobp.2019.03.014 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2019 Jul 15;104(4):801-808. doi:
      10.1016/j.ijrobp.2019.03.014. Epub 2019 Mar 16.