Impact of long-term androgen deprivation therapy on PSMA ligand PET/CT in patients with castration-sensitive prostate cancer
PurposeSince the introduction of PSMA PET/CT with 68Ga-PSMA-11, this modality for imaging prostate cancer (PC) has spread worldwide. Preclinical studies have demonstrated that short-term androgen deprivation therapy (ADT) can significantly increase PSMA expression on PC cells. Additionally, retrospe...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
7 July 2018
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| In: |
European journal of nuclear medicine and molecular imaging
Year: 2018, Volume: 45, Issue: 12, Pages: 2045-2054 |
| ISSN: | 1619-7089 |
| DOI: | 10.1007/s00259-018-4079-z |
| Online Access: | Verlag, Volltext: https://doi.org/10.1007/s00259-018-4079-z
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| Author Notes: | Ali Afshar-Oromieh, Nils Debus, Monika Uhrig, Thomas A. Hope, Michael J. Evans, Tim Holland-Letz, Frederik L. Giesel, Klaus Kopka, Boris Hadaschik, Clemens Kratochwil, Uwe Haberkorn |
| Summary: | PurposeSince the introduction of PSMA PET/CT with 68Ga-PSMA-11, this modality for imaging prostate cancer (PC) has spread worldwide. Preclinical studies have demonstrated that short-term androgen deprivation therapy (ADT) can significantly increase PSMA expression on PC cells. Additionally, retrospective clinical data in large patient cohorts suggest a positive association between ongoing ADT and a pathological PSMA PET/CT scan. The present evaluation was conducted to further analyse the influence of long-term ADT on PSMA PET/CT findings.MethodsA retrospective analysis was performed of all 1,704 patients who underwent a 68Ga-PSMA-11 PET/CT scan at our institution from 2011 to 2017 to detect PC. Of 306 patients scanned at least twice, 10 had started and continued ADT with a continuous clinical response between the two PSMA PET/CT scans. These ten patients were included in the current analysis which compared the tracer uptake intensity and volume of PC lesions on PSMA PET/CT before and during ongoing ADT.ResultsOverall, 31 PC lesions were visible in all ten patients before initiation of ADT. However, during ongoing ADT (duration 42-369 days, median 230 days), only 14 lesions were visible in eight of the ten patients. The average tracer uptake values decreased in 71% and increased in 12.9% of the PC lesions. Of all lesions, 33.3% were still visible in six patients with a complete PSA response (≤0.1 ng/ml).ConclusionContinuous long-term ADT significantly reduces the visibility of castration-sensitive PC on PSMA PET/CT. If the objective is visualization of the maximum possible extent of disease, we recommend referring patients for PSMA PET/CT before starting ADT. |
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| Item Description: | Gesehen am 10.05.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1619-7089 |
| DOI: | 10.1007/s00259-018-4079-z |