68 Ga-PSMA-11 PET/CT in primary and recurrent prostate carcinoma: Implications for radiotherapeutic management in 121 patients

Abstract

The present study analyzed the impact of 68 Ga-labeled prostate-specific membrane antigen-HBED-CC ( 68 Ga-PSMA-11) PET/CT on radiotherapeutic management in a large cohort of men with primary or recurrent prostate cancer. Methods: This study investigated 121 men with carcinoma of the prostate who underwent 68 Ga-PSMA-11 PET/CT as well as conventional imaging. Fifty patients were treatment-naive, 11 had persistent prostate-specific antigen (PSA) soon after surgery, and 60 presented with recurrent PSA after definitive therapy. Changes in TNM classification of malignant tumor stage (TNM) and radiotherapeutic management after 68 Ga-PSMA-11 imaging were compared with results achieved with conventional imaging. Results: In total, a change in TNM stage and radiotherapeutic management was observed for 49 patients (40.5%) and 62 patients (51.2%), respectively. In treatment-naive patients, a change in TNM stage and radiotherapeutic plan occurred in 26.0% and 44.0% of the cohort, respectively. For patients with PSA persistence or recurrence, TNM and radiotherapeutic management changed in 50.7% and 56.3%, respectively. Conclusion: 68 Ga-PSMA-11 PET/ CT may shortly become an indispensable tool for detecting prostate cancer lesions in treatment-naive patients as well as in men with recurrent disease or persistent PSA and seems to be helpful in personalizing radiotherapeutic management to the individual patients’ distribution of disease.