The impact of 68Ga-PSMA PET/CT on management intent in prostate cancer: Results of an australian prospective multicenter study

Paul J. Roach, Roslyn Francis, Louise Emmett, Edward Hsiao, Andrew Kneebone, George Hruby, Thomas Eade, Quoc A. Nguyen, Benjamin D. Thompson, Thomas Cusick, Michael McCarthy, Colin I. Tang, Bao Ho, Philip D. Stricker, Andrew M. Scott

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138 Citations (Scopus)

Abstract

68Ga-PSMA PET/CT scanning has been shown to be more sensitive than conventional imaging techniques in patients with prostate cancer. This prospective Australian multicenter study assessed whether 68Ga-PSMA PET/CT imaging affects management intent in patients with primary or recurrent prostate cancer. Methods: Before undertaking 68Ga-PSMA PET imaging, referring medical specialists completed a questionnaire detailing relevant demographic and clinical data as well as their proposed management plan. A separate followup questionnaire was completed after the 68Ga-PSMA PET/CT scan results were available to determine whether the management plan would change. Results: A total of 431 patients with prostate cancer from 4 Australian centers had pre– and post–68Ga-PSMA management plans completed. Scans were obtained for primary staging of intermediate- and high-risk disease in 25% of patients and for restaging/biochemical recurrence in 75% of patients. Overall, 68Ga-PSMA PET/CT scanning led to a change in planned management in 51% of patients. The impact was greater in the group of patients with biochemical failure after definitive surgery or radiation treatment (62% change in management intent) than in patients undergoing primary staging (21% change). Imaging with 68Ga-PSMA PET/CT revealed unsuspected disease in the prostate bed in 27% of patients, locoregional lymph nodes in 39%, and distant metastatic disease in 16%. Conclusion: 68Ga-PSMA PET/CT scans detect previously unsuspected disease and may influence planned clinical management in a high proportion of patients with prostate cancer. The impact was greater in patients with biochemical recurrence. These results demonstrate the potential clinical value of 68Ga-PSMA PET/CT in management of prostate cancer.

Original languageEnglish
Pages (from-to)82-88
Number of pages7
JournalJournal of Nuclear Medicine
Volume59
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

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