| Summary: | Background: The sensitivity and specificity of bone
scintigraphy and thoraco-abdominopelvic CT scans traditionally used for the
staging of prostate cancer don’t meet clinical requirements. In 2020
18F-JK-PSMA-7 positron emission tomography-computed tomography (PET-CT) became available in our country for routine clinical diagnostics.
Methods: As part of our self-assessment, we
retrospectively analysed the results of 24 PSMA PET-CTs realised for our patients
up to 31 December 2020.
Results: The indication of the examination was biochemical recurrence
after radical prostatectomy (prostate specific antigen (PSA) >0.2 ng/mL) for 16
patients and primary staging (PSA range: 5.2–70 ng/mL) for 8 patients.
Biochemical recurrence was related to local relapse in 2 cases, regional lymph
node involvement in 5 cases, oligo- and multi-metastatic spread in 1 and 3 cases
respectively. 5 patients had no detectable lesion. Patients with PSA <1 ng/mL
showed no extrapelvic enhancement. At primary staging 3 patients presented
distant metastases. There was no correlation between PSA level and disease
extent. In total PSMA PET-CT results changed the treatment strategy for 7
patients.
Conclusions: 18F-JK-PSMA-7 PET-CT is a useful diagnostic tool. The
examination can lead to change the treatment decision at primary staging as well
as at biochemical recurrence. The results of this pilot study may support the
strategy that patients with biochemical recurrence following radical
prostatectomy receive salvage radiotherapy to the prostate bed and the pelvic
lymphatic regions without any imaging examination when PSA <1 ng/mL.
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