Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity?
Aim of the study: To draw inferences from a retrospective evaluation of PSMA PET CT scans performed for the evaluation of biochemical recurrence. Material and Methods: A retrospective analysis of 295 PSMA PET CT scans spanning 3 years between 2020 and 2022 was undertaken. Results: Of 295 PET CT scan...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-07-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/15/2542 |
| _version_ | 1797586868989067264 |
|---|---|
| author | Vineet Pant Sobhan Vinjamuri Ahmad Zaid Zanial Faisal Naeem |
| author_facet | Vineet Pant Sobhan Vinjamuri Ahmad Zaid Zanial Faisal Naeem |
| author_sort | Vineet Pant |
| collection | DOAJ |
| description | Aim of the study: To draw inferences from a retrospective evaluation of PSMA PET CT scans performed for the evaluation of biochemical recurrence. Material and Methods: A retrospective analysis of 295 PSMA PET CT scans spanning 3 years between 2020 and 2022 was undertaken. Results: Of 295 PET CT scans, 179 were positive, 66 were negative and 50 had indeterminate findings. In the positive group, 67 had radical prostatectomy and PSMA avid lesions were seen most commonly in pelvic lymph nodes. The remaining 112 positive scans were in the non-radical prostatectomy group; 25 had recurrence only in the prostate, 17 had recurrence involving the prostate bed; 28 had no recurrence in the prostate gland, while 42 had recurrence in the prostate as well as in extra-prostatic sites. Overall, in the non-prostatectomy group, 75% of the population was harboring a PSMA avid lesion in the prostate gland while in the remaining 25% of the population, recurrence did not involve the prostate gland. The majority of indeterminate findings were seen in small pelvic or retroperitoneal lymph nodes or skeletal regions (ribs/others) and in nine patients indeterminate focus was seen in the prostate bed only. Follow-up PSMA PET CT was helpful in prior indeterminate findings and unexplained PSA rise. Conclusion: A higher recurrence in the prostate bed while evaluating biochemical recurrence prompts the following: question: should prostatectomy be offered more proactively? Follow-up PSMA PET CT is helpful for indeterminate findings; a PSA rise of 0.7 ng/mL in 6 months can result in positive PSMA PET CT while negative scans can be seen up to a 2 ng/mL PSA rise in 6 months. |
| first_indexed | 2024-03-11T00:29:16Z |
| format | Article |
| id | doaj.art-4382a59e7e3a415cbbeaf61fba67a8b7 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T00:29:16Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4382a59e7e3a415cbbeaf61fba67a8b72023-11-18T22:46:53ZengMDPI AGDiagnostics2075-44182023-07-011315254210.3390/diagnostics13152542Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity?Vineet Pant0Sobhan Vinjamuri1Ahmad Zaid Zanial2Faisal Naeem3Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool L78XP, UKDepartment of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool L78XP, UKDepartment of Nuclear Medicine, General Hospital, Kuala Lumpur 50586, MalaysiaDepartment of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool L78XP, UKAim of the study: To draw inferences from a retrospective evaluation of PSMA PET CT scans performed for the evaluation of biochemical recurrence. Material and Methods: A retrospective analysis of 295 PSMA PET CT scans spanning 3 years between 2020 and 2022 was undertaken. Results: Of 295 PET CT scans, 179 were positive, 66 were negative and 50 had indeterminate findings. In the positive group, 67 had radical prostatectomy and PSMA avid lesions were seen most commonly in pelvic lymph nodes. The remaining 112 positive scans were in the non-radical prostatectomy group; 25 had recurrence only in the prostate, 17 had recurrence involving the prostate bed; 28 had no recurrence in the prostate gland, while 42 had recurrence in the prostate as well as in extra-prostatic sites. Overall, in the non-prostatectomy group, 75% of the population was harboring a PSMA avid lesion in the prostate gland while in the remaining 25% of the population, recurrence did not involve the prostate gland. The majority of indeterminate findings were seen in small pelvic or retroperitoneal lymph nodes or skeletal regions (ribs/others) and in nine patients indeterminate focus was seen in the prostate bed only. Follow-up PSMA PET CT was helpful in prior indeterminate findings and unexplained PSA rise. Conclusion: A higher recurrence in the prostate bed while evaluating biochemical recurrence prompts the following: question: should prostatectomy be offered more proactively? Follow-up PSMA PET CT is helpful for indeterminate findings; a PSA rise of 0.7 ng/mL in 6 months can result in positive PSMA PET CT while negative scans can be seen up to a 2 ng/mL PSA rise in 6 months.https://www.mdpi.com/2075-4418/13/15/2542biochemical recurrenceprostate cancerrecurrenceindeterminate PSMA PET |
| spellingShingle | Vineet Pant Sobhan Vinjamuri Ahmad Zaid Zanial Faisal Naeem Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? Diagnostics biochemical recurrence prostate cancer recurrence indeterminate PSMA PET |
| title | Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? |
| title_full | Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? |
| title_fullStr | Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? |
| title_full_unstemmed | Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? |
| title_short | Lessons from a 3-Year Review of PSMA PET-CT in a Tertiary Setting: Can We Fine Tune Referral Criteria by Identifying Factors Predicting Positivity and Negativity? |
| title_sort | lessons from a 3 year review of psma pet ct in a tertiary setting can we fine tune referral criteria by identifying factors predicting positivity and negativity |
| topic | biochemical recurrence prostate cancer recurrence indeterminate PSMA PET |
| url | https://www.mdpi.com/2075-4418/13/15/2542 |
| work_keys_str_mv | AT vineetpant lessonsfroma3yearreviewofpsmapetctinatertiarysettingcanwefinetunereferralcriteriabyidentifyingfactorspredictingpositivityandnegativity AT sobhanvinjamuri lessonsfroma3yearreviewofpsmapetctinatertiarysettingcanwefinetunereferralcriteriabyidentifyingfactorspredictingpositivityandnegativity AT ahmadzaidzanial lessonsfroma3yearreviewofpsmapetctinatertiarysettingcanwefinetunereferralcriteriabyidentifyingfactorspredictingpositivityandnegativity AT faisalnaeem lessonsfroma3yearreviewofpsmapetctinatertiarysettingcanwefinetunereferralcriteriabyidentifyingfactorspredictingpositivityandnegativity |