Bridging the imaging gap: PSMA PET/CT has a high impact on treatment planning in prostate cancer patients with biochemical recurrence - a narrative review of literature.

Ekmekcioglu, Ozgul; Busstra, Martijn; Klass, Natalie Désirée; Verzijlbergen, Fred (2019). Bridging the imaging gap: PSMA PET/CT has a high impact on treatment planning in prostate cancer patients with biochemical recurrence - a narrative review of literature. Journal of nuclear medicine, 60(10), pp. 1394-1398. Society of Nuclear Medicine 10.2967/jnumed.118.222885

Text J Nucl Med-2019-Ekmekcioglu-jnumed.118.222885.pdf - Accepted Version Restricted to registered users only Available under License Publisher holds Copyright. Download (975kB)

Gallium-68 and Fluor-18 labeled prostate specific membrane antigen (PSMA) molecules have created new opportunities for the unmet diagnostic needs in prostate cancer. The purpose of this study is to give an overview of the studies that have examined the role of PSMA PET scan in treatment planning in prostate cancer patients with biochemical recurrence. Medline, Embase, Web of Science, Google Scholar, and Cochrane Central were searched for relevant articles. After excluding the articles that did not fulfill the required criteria, 12 publications that reported the impact of PSMA-PET on the treatment plan in prostate cancer patients with biochemical recurrence (BCR) were included in the review. All the studies in our review emphasized the impact of PSMA PET images on therapy management in prostate cancer patients with biochemical recurrence. Overall, the impact of PSMA PET/CT on therapy management varied between 30-76% among the 1,346 patients included in the review. Upstaging was reported in 32% to 67% of the patients. Patients with low PSA values (< 0.5 ng/ml) also demonstrated positive lesions, which could not have been detected by means of conventional imaging techniques. Important modifications to the original treatment plan included avoidance of systemic therapy (17-40%) and PET-directed local therapy (in up to 60% of the patients). PSMA imaging demonstrated a high clinical impact in patients with BCR with modifications to the original treatment plan among half of the patients. Detecting recurrence in BCR can prevent unnecessary toxicity and lead to individualized therapy.

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