68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy

Abstract Biochemical recurrence (BCR) of prostate cancer (PCa) occurs in about 25% of patients treated with radical prostatectomy (RP) and up to 45% in patients who receive external beam radiotherapy (RT). Early diagnosis of PCa recurrence is of high importance for successful salvage therapy. The ai...

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Main Authors: Mohamad Haidar, Alain S. Abi-Ghanem, Hicham Moukaddam, Malak El Jebai, Safaa Al Zakleet, Samir Al Rayess, Abdul Rahman Akkawi, Mutaz Kassas, Hani Tamim, Albert El Hajj, Enrique Estrada-Lobato, Medhat M. Osman, Ali Shamseddine
Format: Article
Language:English
Published: Nature Portfolio 2022-11-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-24688-3
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author Mohamad Haidar
Alain S. Abi-Ghanem
Hicham Moukaddam
Malak El Jebai
Safaa Al Zakleet
Samir Al Rayess
Abdul Rahman Akkawi
Mutaz Kassas
Hani Tamim
Albert El Hajj
Enrique Estrada-Lobato
Medhat M. Osman
Ali Shamseddine
author_facet Mohamad Haidar
Alain S. Abi-Ghanem
Hicham Moukaddam
Malak El Jebai
Safaa Al Zakleet
Samir Al Rayess
Abdul Rahman Akkawi
Mutaz Kassas
Hani Tamim
Albert El Hajj
Enrique Estrada-Lobato
Medhat M. Osman
Ali Shamseddine
author_sort Mohamad Haidar
collection DOAJ
description Abstract Biochemical recurrence (BCR) of prostate cancer (PCa) occurs in about 25% of patients treated with radical prostatectomy (RP) and up to 45% in patients who receive external beam radiotherapy (RT). Early diagnosis of PCa recurrence is of high importance for successful salvage therapy. The aim of the present study is to analyze the efficacy of 68 Ga-PSMA PET/CT in detecting the presence of local and/or systemic disease in patients with a history of PCa who have BCR. A total of 52 PCa patients with BCR referred for 68 Ga-PSMA PET/CT were recruited from the American University of Beirut Medical Center between November 2017 and December 2019. We compared the performance of PSMA PET/CT to the results and clinical factors based on follow up: PSA, PSA kinetics, primary treatment, and Gleason score. The relationship between the PET/CT findings and clinical indicators of disease were assessed by univariate and multivariate logistic regression. From a total of 52 patients, 34 (65.4%) had positive PSMA-PET/CT scans. Among those, 8/34 (23.5%) received primary RT. For all patients with a positive PSMA-PET: the detection rate was 2/4 (50%) for PSA < 0.2, 5/10 (50%) for PSA 0.2–0.49, 3/6 (50%) for PSA 0.5–0.99, 6/12 (50%) for PSA 1–1.99, 8/9 (88.9%) for PSA 2–3.99, and 10/11 (90.9%) for PSA 4–10. PSMA-PET/CT positivity was significantly associated with PSA level at time of PET scan, PSA doubling time, Gleason score and TNM staging. However, it did not show a significant correlation with radiotherapy as primary treatment, ongoing androgen deprivation therapy (ADT), time to relapse, and initial PSA before therapy. In our single center prospective trial, 68 Ga-PSMA PET/CT successfully detected the recurrence of PCa in patients with BCR. Scan positivity was significantly associated with PSA level at time of PET scan, PSA doubling time, Gleason score, and TNM staging. PSMA- PET/CT is a highly promising modality in the work up of patients with PCa in the setting of BCR for earlier detection of disease recurrence.
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spelling doaj.art-0f21e5387bf0418fa562b92bfd3388892022-12-22T04:37:51ZengNature PortfolioScientific Reports2045-23222022-11-011211910.1038/s41598-022-24688-368Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapyMohamad Haidar0Alain S. Abi-Ghanem1Hicham Moukaddam2Malak El Jebai3Safaa Al Zakleet4Samir Al Rayess5Abdul Rahman Akkawi6Mutaz Kassas7Hani Tamim8Albert El Hajj9Enrique Estrada-Lobato10Medhat M. Osman11Ali Shamseddine12Department of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterDepartment of Internal Medicine, University of Kansas School of Medicine-WichitaDepartment of Diagnostic Radiology, Faculty of Medicine, American University of Beirut Medical CenterClinical Research Institute, American University of BeirutDivision of Urology, Department of Surgery, American University of Beirut Medical CenterNuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy AgencyDivision of Nuclear Medicine, Department of Radiology, Saint Louis University HospitalDepartment of Internal Medicine, Division of Hematology and Oncology, Faculty of Medicine, Naef K. Basile Cancer Institute, American University of Beirut Medical CenterAbstract Biochemical recurrence (BCR) of prostate cancer (PCa) occurs in about 25% of patients treated with radical prostatectomy (RP) and up to 45% in patients who receive external beam radiotherapy (RT). Early diagnosis of PCa recurrence is of high importance for successful salvage therapy. The aim of the present study is to analyze the efficacy of 68 Ga-PSMA PET/CT in detecting the presence of local and/or systemic disease in patients with a history of PCa who have BCR. A total of 52 PCa patients with BCR referred for 68 Ga-PSMA PET/CT were recruited from the American University of Beirut Medical Center between November 2017 and December 2019. We compared the performance of PSMA PET/CT to the results and clinical factors based on follow up: PSA, PSA kinetics, primary treatment, and Gleason score. The relationship between the PET/CT findings and clinical indicators of disease were assessed by univariate and multivariate logistic regression. From a total of 52 patients, 34 (65.4%) had positive PSMA-PET/CT scans. Among those, 8/34 (23.5%) received primary RT. For all patients with a positive PSMA-PET: the detection rate was 2/4 (50%) for PSA < 0.2, 5/10 (50%) for PSA 0.2–0.49, 3/6 (50%) for PSA 0.5–0.99, 6/12 (50%) for PSA 1–1.99, 8/9 (88.9%) for PSA 2–3.99, and 10/11 (90.9%) for PSA 4–10. PSMA-PET/CT positivity was significantly associated with PSA level at time of PET scan, PSA doubling time, Gleason score and TNM staging. However, it did not show a significant correlation with radiotherapy as primary treatment, ongoing androgen deprivation therapy (ADT), time to relapse, and initial PSA before therapy. In our single center prospective trial, 68 Ga-PSMA PET/CT successfully detected the recurrence of PCa in patients with BCR. Scan positivity was significantly associated with PSA level at time of PET scan, PSA doubling time, Gleason score, and TNM staging. PSMA- PET/CT is a highly promising modality in the work up of patients with PCa in the setting of BCR for earlier detection of disease recurrence.https://doi.org/10.1038/s41598-022-24688-3
spellingShingle Mohamad Haidar
Alain S. Abi-Ghanem
Hicham Moukaddam
Malak El Jebai
Safaa Al Zakleet
Samir Al Rayess
Abdul Rahman Akkawi
Mutaz Kassas
Hani Tamim
Albert El Hajj
Enrique Estrada-Lobato
Medhat M. Osman
Ali Shamseddine
68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
Scientific Reports
title 68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
title_full 68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
title_fullStr 68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
title_full_unstemmed 68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
title_short 68Ga-PSMA PET/CT in early relapsed prostate cancer patients after radical therapy
title_sort 68ga psma pet ct in early relapsed prostate cancer patients after radical therapy
url https://doi.org/10.1038/s41598-022-24688-3
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