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Detection rate, pattern of relapse and influence on therapeutic decision of PSMA PET/CT in patients affected by biochemical recurrence after radical prostatectomy, a retrospective case series

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Abstract

Aims

68Ga-Prostate-specific membrane antigen (PSMA) PET/CT is widely used in patients with biochemical recurrence (BCR) after radical prostatectomy. We collected data about patients staged with PSMA PET/CT after BCR (PSA < 1 ng/ml) in four different institutes. Impact of baseline features (Gleason score, risk classification, PSA at recurrence, PSA doubling time and time to recurrence) was explored to understand predictive factors of (PSMA) PET/CT positivity. Impact of restaging on following treatment approaches was reported.

Results

92 patients were included. PSMA PET/CT detection rate was 56.5% and low-volume disease (≤ 3 non-visceral lesions) was detected in 52.2% of patients. After positive scan, 13.5% of patients still lies on observation, ADT alone was administered in 30.8% of cases, Stereotactic body RT (SBRT) alone was delivered to 44.2% of patients and 11.5% of patients underwent concomitant SBRT and ADT. Seven patients underwent conventional salvage prostate bed RT. Chi-squared test showed a higher rate of positive PSMA PET/CT for patients with Gleason score > 7 (p = 0.004) and TTR < 29.5 months (p = 0.003).

Conclusions

PSMA PET/CT showed a high detection rate. This influenced clinical management in a significant percentage of patients, allowing treatment tailoring on the basis of imaging.

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Authors and Affiliations

  1. Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy

    G. Francolini, B. Detti, M. Mariotti, M. A. Teriaca, V. Maragna & L. Livi

  2. Department of Radiation Oncology, Policlinico Tor Vergata, University of Rome, Rome, Italy

    M. Bottero

  3. Radiation Oncology Division, Geneva University Hospital, Geneva, Switzerland

    T. Zilli

  4. Radiation Oncology Unit, Department of Medical Sciences and Infectious Disease, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy

    A. Lancia & A. R. Filippi

  5. Radiotherapy Unit, University Hospital of Modena, Modena, Italy

    A. Bruni & E. Mazzeo

  6. UOC Radiation Oncology Arezzo-Valdarno, Azienda USL Toscana Sud Est, Arezzo, Italy

    S. Borghesi

  7. Department of Nuclear Medicine, Policlinico S. Orsola-Malpighi, Bologna, Italy

    P. Castellucci & S. Fanti

  8. Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy

    C. Aristei & G. Ingrosso

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  1. G. Francolini
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Correspondence to G. Francolini.

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Francolini, G., Detti, B., Bottero, M. et al. Detection rate, pattern of relapse and influence on therapeutic decision of PSMA PET/CT in patients affected by biochemical recurrence after radical prostatectomy, a retrospective case series. Clin Transl Oncol 23, 364–371 (2021). https://doi.org/10.1007/s12094-020-02427-2

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