scholarly journals 18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for staging of high-risk prostate cancer patients

2018 ◽  
Vol 13 (4) ◽  
Author(s):  
Simon Gauvin ◽  
Alexis Rompré-Brodeur ◽  
Guillaume Chaussé ◽  
Maurice Anidjar ◽  
Franck Bladou ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
High Risk ◽  
Metastatic Disease ◽  
Conventional Imaging ◽  
Predictive Values ◽  
High Risk Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
Risk Prostate Cancer

Introduction: We sought to evaluate the diagnostic performance of 18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for initial staging of patients with high-risk prostate cancer. Secondary objectives were to compare the value of 18F-FCH PET/CT to conventional imaging modalities and to evaluate its clinical impact. Methods: We conducted a retrospective study of 76 patients who underwent 18F-FCH PET/CT for initial staging of high-risk prostate cancer. Using pre-established validation criteria, sensitivity and specificity were determined for metastatic disease. Results were compared to findings on magnetic resonance imaging (MRI), computed tomography (CT), and bone scan (BS) when available. Results: Twenty-two (29%) PET/CT scans were positive, 49 (64%) negative, and five (7%) equivocal for nodal or metastatic disease. Of the positive scans, 17 showed regional lymph node involvement, 12 distant nodes, five bone metastases, and three lung metastases. Overall per-patient sensitivity, specificity, positive and negative predictive values for metastatic disease were 65%, 100%, 100%, and 78%, respectively. Sensitivity, specificity, and positive and negative predictive values were 64%, 100%, 100%, and 80%, respectively, for nodal involvement and 86%, 100%, 100%, and 98%, respectively, for bone and other metastases. Conventional imaging was negative for the lesion(s) found on PET/CT in five patients. PET/CT changed the clinical management in nine patients (12%). Conclusions: Although 18F-FCH PET/CT offers some benefits over conventional imaging and demonstrates a high specificity, it remains limited by its sensitivity in the context of high-risk prostate cancer staging. PET with novel urea-based small molecule prostate-specific membrane antigen (PSMA) inhibitors may overcome some of these limitations. However, the interpretation of the study result is limited by the lack of available histological gold standard, the inclusion of several patients who received androgen-deprivation therapy (ADT) prior to PET/CT, our retrospective design, and a relatively small sample size.

The “ProPSMA Study” clinical trial protocol: A prospective randomized multi-center study of the impact of Ga-68 PSMA PET/CT imaging for staging high-risk prostate cancer prior to curative-intent surgery or radiotherapy.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. TPS138-TPS138 ◽  
Author(s):  
Michael Hofman ◽  
Declan G. Murphy ◽  
Scott Williams ◽  
Tatenda Nzenza ◽  
Alan Herschtal ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trial ◽  
High Risk ◽  
Conventional Imaging ◽  
Curative Intent ◽  
High Risk Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Risk Prostate Cancer

TPS138 Background: Disease persistence or relapse following curative-intent surgery or radiotherapy of high-risk prostate cancer is not uncommon. This is attributable, in part, to a failure of accurate staging with diagnostic imaging being insensitive for detection of small volume metastatic disease. Prostate-specific-membrane-antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is a new whole body scanning technique that enables visualisation of prostate cancer with high sensitivity. The hypotheses of this study are that PSMA-PET/CT (a) has improved diagnostic accuracy compared to conventional imaging, (b) should be used as a first-line diagnostic test for staging, (c) the improved diagnostic accuracy will result in significant management impact and (d) provides economic benefits when incorporated into the management algorithm. Methods: This is a 300 patient phase III multi-centre randomized study of patients with untreated high-risk prostate cancer defined by Gleason grade group 3-5, PSA ≥ 20ng/ml or clinical stage ≥ T3. Patients are randomized to Gallium-68-PSMA11 PET/CT or conventional imaging, consisting of computer tomography of the abdomen/pelvis and bone scintigraphy with SPECT/CT. Patients with negative, equivocal or oligometastatic disease cross-over to receive the other imaging arm. The primary objective is to compare the accuracy of PSMA-PET/CT to conventional imaging for detecting nodal or distant metastatic disease. Accuracy is defined by a pre-defined “ground truth” scoring system incorporating histopathologic, imaging and clinical follow-up at six months post randomisation. Secondary objectives include comparing management impact, the number of equivocal studies, the incremental value of second-line imaging in patients who cross-over, health economics, radiation exposure, inter-observer agreement and safety of PSMA-PET/CT. Longer term follow-up will also assess the prognostic value of a negative PSMA-PET/CT. 294 of 300 (98%) patients randomised at time of abstract submission. Clinical trial information: 12617000005358.

scholarly journals The significance of pelvis positron emission tomography and magnetic resonance tomography for surgical planning in patients with high risk prostate cancer

2019 ◽  
Vol 9 (1) ◽  
pp. 38-41
Author(s):  
M. Sh. Shikhzadaev ◽  
M. I. Shkolnik ◽  
A. A. Stanjevskiy ◽  
O. A. Bogomolov ◽  
A. L. Dolbov
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Surgical Planning ◽  
Magnetic Resonance Tomography ◽  
Diagnostic Value ◽  
High Risk Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
Risk Prostate Cancer ◽  
Pet Ct Scan

The article concerns the diagnostic value of PET/CT scan for surgical planning in patients with high‑risk prostate cancer.

scholarly journals Examination of high-risk prostate cancer patients: real practice in Russia

2021 ◽  
Vol 14 (3) ◽  
pp. 80-85
Author(s):  
S.A. Reva ◽  
◽  
I.A. Shaderkin ◽  
I.V. Zyatchin ◽  
A.V. Arnautov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Locally Advanced ◽  
Digital Rectal Examination ◽  
Primary Diagnosis ◽  
High Risk Prostate Cancer ◽  
Radiological Diagnostics ◽  
Positron Emission ◽  
Pet Ct ◽  
Risk Prostate Cancer

Introduction. Approaches to the diagnosis and staging of localized and locally advanced high-risk prostate cancer (PCa-НR) continue to be actively researched and improved. Materials and methods. In order to understand some of the controversial and controversial issues regarding the diagnosis of PCа-НR, a survey was conducted, in which 250 specialists took part – oncourologists, urologists, andrologists, specializing in the treatment / observation of patients with prostate cancer (PCа). The survey was conducted within the urological information portal Uroweb.ru by filling out a questionnaire. Results. The results obtained indicate that the most significant differences were obtained in views on the role of positron emission tomography combined with computed tomography (PET/CT) in the primary diagnosis of non-metastatic PCа and the importance of local prevalence in determining the risk of progression, while the attitude to genetic testing, primary local staging and prognosis criteria after radical prostatectomy in the majority respondents were similar. Conclusions. Most Russian oncourologists specialists involved in the treatment of PCа do not recommend that patients with PCа-HR perform PET/CT with prostate specific membrane antigen (68Ga-PSMA) and do not prescribe geneticist consultation and genetic counseling for non-metastatic PCа. To assess the local prevalence of the process in prostate cancer, based on the results of MRI, digital rectal examination and the percentage of tumor tissue in the biopsy sample. Most specialists determine the prognosis of a patient after RP by summing up the pathomorphological (PSA + radiological diagnostics + the result of histological examination) and clinical (PSA + radiological diagnostics + biopsy) indicators, which quite correlates with the global data.

11C-Acetate-PET/CT Compared to 99mTc-HDP Bone Scintigraphy in Primary Staging of High-risk Prostate Cancer

2016 ◽  
Vol 36 (12) ◽  
pp. 6475-6480 ◽  
Author(s):  
SARA STRANDBERG ◽  
CAMILLA THELLENBERG KARLSSON ◽  
MATTIAS OGREN ◽  
JAN AXELSSON ◽  
KATRINE RIKLUND
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Bone Scintigraphy ◽  
Primary Staging ◽  
High Risk Prostate Cancer ◽  
Pet Ct ◽  
Risk Prostate Cancer
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