Research Papers:

The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

Manuela A. Hoffmann _, Hans-Georg Buchholz, Helmut J. Wieler, Thomas Höfner, Jonas Müller-Hübenthal, Ludwin Trampert and Mathias Schreckenberger

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Oncotarget. 2019; 10:6124-6137. https://doi.org/10.18632/oncotarget.27239

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Manuela A. Hoffmann1,2,3, Hans-Georg Buchholz2, Helmut J. Wieler3, Thomas Höfner4, Jonas Müller-Hübenthal5, Ludwin Trampert6 and Mathias Schreckenberger2

1 Department of Occupational Health and Safety, Supervisory Center for Radiation Protection, Federal Ministry of Defense, Bonn 53123, Germany

2 Clinic of Nuclear Medicine, Johannes Gutenberg-University, Mainz 55101, Germany

3 Clinic of Nuclear Medicine, Bundeswehr Central Hospital, Koblenz 56072, Germany

4 Clinic of Urology, Johannes Gutenberg-University, Mainz 55101, Germany

5 Practice of Radiology and Nuclear Medicine, Praxis im KölnTriangle, Köln 50679, Germany

6 Clinic of Nuclear Medicine, Klinikum Mutterhaus der Borromäerinnen, Trier 54290, Germany

Correspondence to:

Manuela A. Hoffmann,email: manuhoffmann@web.de

Keywords: positivity rate; 68Gallium-PSMA PET/CT; prostate-specific antigen; prostate cancer; biochemical recurrence

Received: July 04, 2019     Accepted: September 10, 2019     Published: October 22, 2019


Background: The aim of the present study is to analyze the efficacy of 68Gallium (Ga)-PSMA-11 PET/CT for detecting and localizing recurrent prostate carcinoma (PC) in patients with different prostate-specific antigen (PSA), PSA velocity (PSAvel) and doubling time (PSAdt).

Results: The PR of 68Ga-PSMA-11 PET/CT showed a positive relationship with PSA levels. Even at restaging PSA-values (PSAV) of lower than 0.2 ng/ml, PR was 41%. For PSAV of 0.2-<0.5 ng/ml the PR was 45%, 62% for PSAV of 0.5-<1.0 and 72% for PSAV of 1.0-<2.0 ng/ml. The PR increased to 85% for PSAV of 2.0-<5.0 and reached 94% at PSAV of ≥5.0 ng/ml. At PSA of <1 ng/ml/y the PR of PSAvel was 50% and increased to 98% at PSA >5 ng/ml/y. No significant association was found for PSAdt.

Methods: PET/CT scans of 660 patients with biochemical recurrence (BCR) after primary therapy of PC were included in the analysis. We correlated serum PSA levels, measured at the time of imaging with PSMA PET/CT-positivity rates (PR) as well as PSAvel (in 225 patients) and PSAdt (660 patients). Additionally we compared the incidence of localized disease to metastases as related to these PSA-biomarkers.

Conclusion: We have shown, in a large cohort of patients, that 68Ga-PSMA-11 PET/CT is a sensitive tool for restaging PC and has a high detection efficacy, even in patients with very low PSA levels (<0.2 ng/ml). Thus 68Ga-PSMA-11 PET/CT both identify and localize recurrent disease with implications for a more direct treatment approach (localized vs. systemic therapy).

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