Impact of long-term androgen deprivation therapy on PSMA ligand PET/CT in patients with castration-sensitive prostate cancer

• Verfasst von: Afshar-Oromieh, Ali [VerfasserIn]
• Verfasst von: Debus, Nils [VerfasserIn]
• Verfasst von: Holland-Letz, Tim [VerfasserIn]
• Verfasst von: Giesel, Frederik L. [VerfasserIn]
• Verfasst von: Kopka, Klaus [VerfasserIn]
• Verfasst von: Kratochwil, Clemens [VerfasserIn]
• Verfasst von: Haberkorn, Uwe [VerfasserIn]
• Verfasst von: Uhrig, Monika [VerfasserIn]
• Titel: Impact of long-term androgen deprivation therapy on PSMA ligand PET/CT in patients with castration-sensitive prostate cancer
• Verf.angabe: 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
• E-Jahr: 2018
• Jahr: 7 July 2018
• Umfang: 10 S.
• Fussnoten: Gesehen am 10.05.2019
• Titel Quelle: Enthalten in: European journal of nuclear medicine and molecular imaging
• Ort Quelle: Heidelberg [u.a.] : Springer-Verl., 2002
• Jahr Quelle: 2018
• Band/Heft Quelle: 45(2018), 12, Seite 2045-2054
• ISSN Quelle: 1619-7089
• DOI: doi:10.1007/s00259-018-4079-z
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: 68Ga-PSMA-11
• Sach-SW: Androgen deprivation therapy
• Sach-SW: PET/CT
• Sach-SW: Prostate cancer
• Sach-SW: Prostate-specific membrane antigen
• Sach-SW: PSMA
• K10plus-PPN: 166511813X

Abstract

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.