68Ga-PSMA-11 PET/CT for prostate cancer staging and risk stratification in Chinese patients
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Shiming Zang1,*, Guoqiang Shao1,*, Can Cui1, Tian-Nv Li2, Yue Huang3, Xiaochen Yao1, Qiu Fan1, Zejun Chen4, Jin Du5, Ruipeng Jia6, Hongbin Sun6, Zichun Hua7, Jun Tang8, Feng Wang1
1Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
2Department of Nuclear Medicine, PET Centre, No. 1 Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
3Department of Pathology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
4Department of Nuclear Medicine, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin 214400, China
5Department of Technology Development, China Isotope Radiation Corporation, No. 1 Nansixiang, Sanlihe, West District, Beijing 100045, China
6Department of Urology, Nanjing Medical University, Nanjing 210006, China
7The State Key Laboratory of Pharmaceutical Biotechnology, Department of Biochemistry, College of Life Sciences, Nanjing University, Nanjing 210006, China
8Department of Nuclear Medicine, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
*These authors have contributed equally to this work
Feng Wang, email: [email protected]
Hongbin Sun, email: [email protected]
Keywords: treatment-naïve prostate cancer, prostate-specific membrane antigen, metastatic castrate-resistant prostate cancer, staging, risk stratification
Received: July 22, 2016 Accepted: December 27, 2016 Published: January 17, 2017
We evaluated the clinical utility of 68Ga-PSMA-11 PET/CT for staging and risk stratification of treatment-naïve prostate cancer (PCa) and metastatic castrate-resistant prostate cancer (mCRPC). Twenty-two consecutive patients with treatment-naïve PCa and 18 with mCRPC were enrolled. 68Ga-PSMA-11 PET/CT and magnetic resonance imaging (MRI) were performed for the evaluation of primary prostatic lesions, and bone scans were used for evaluation bone metastasis. Among the 40 patients, 37 (92.5% [22 treatment-naïve PCa, 15 mCRPC]) showed PSMA-avid lesions on 68Ga-PSMA-11 images. Only 3 patients with stable mCRPC after chemotherapy were negative for PSMA. The sensitivity, specificity and accuracy of 68Ga-PSMA-11 imaging were 97.3%, 100.0% and 97.5%, respectively. The maximum standardized uptake (SUVmax) of prostatic lesions was 17.09 ± 11.08 and 13.33 ± 12.31 in treatment-naïve PCa and mCRPC, respectively. 68Ga-PSMA-11 revealed 105 metastatic lymph nodes in 15 patients; the SUVmax was 16.85 ± 9.70 and 7.54 ± 5.20 in treatment-naïve PCa and mCRPC, respectively. 68Ga-PSMA-11 PET/CT also newly detected visceral metastasis in 9 patients (22.5%) and bone metastasis in 29 patients (72.5%). 68Ga-PSMA-11 PET/CT exhibits potential for staging and risk stratification in naïve PCa, as well as improved sensitivity for detection of lymph node and remote metastasis.
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