PSMA PET CT: Early experience in a single centre with regards to impact on treatment decisions

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Purpose

Relapsed or progressive prostate cancer frequently manifests as consecutive PSA rises long before disease is clinically detectable. Imaging evaluation with novel radiotracers targeting PMSA has been shown to be more sensitive in identifying the site of disease at lower PSA levels compared to conventional imaging.Thisprovides increased opportunity for salvage therapy, more aggressive local management of oligometastatic disease or increased confidence in proceeding with systemic therapy.[1] We have assessed a cohort of our patients who have received a PMSA PET-CT to impact on management

Methods

Single centre, retrospective assessment of case notes of all patients who have undergone PSMA PET-CT. Likely management in absence of PSMA PET CT was recorded and noted if this was altered based on subsequent scan results.

Results

Twenty-four patients with rising PSA were investigated with conventional imaging plus subsequent PSMA PET-CT. This resulted in altered management in 15 (62.5%) patients. Six patients who would have been treated with standard androgen deprivation therapy were commenced on SACT (novel hormone treatment or docetaxel), 2 patients management plans changed from SABR to SACT and 2 patients radiotherapy treatment volumes were increased. Of 3 patients who would have continued on PSA surveillance, 1 received salvage treatment and 2 SABR treatment. One patient who would have received salvage treatment went on to have SACT and conversely a patient who would have had SACT alternatively received salvage treatment. Two patients who were at higher risk of toxicity from local treatment, had confirmation of localised disease on PET.

Conclusion

Despite the small numbers included in this cohort, the impact on management following PSMA PET-CT imaging is marked and clearly demonstrates clinical utility. Results enabled patients to receive salvage treatment, aggressive management of oligometastatic disease and appropriate systemic treatment.


References
1. Von Eyben FE, Picchio M, von Eyben R, Rhee H, Bauman G. 68Ga-Labeled Prostate-specific Membrane Antigen Ligand Positron Emission Tomography/Computed Tomography for Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Focus. 2018;4(5):686. Epub 2016 Nov 15.
Original languageEnglish
Publication statusPublished - 11 Sept 2020
EventBritish Uro-Ooncology Group Annual Meeting - Virtual
Duration: 11 Sept 2020 → …
https://bug.uk.com/

Conference

ConferenceBritish Uro-Ooncology Group Annual Meeting
Period11/09/2020 → …
Internet address

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