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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Evaluating [68Ga]-Ga PSMA PET/CT for Detecting Prostate Cancer Recurrence Post-High-Intensity Focused Ultrasound and
Andrea Di Giorgio1, Marco Rapa1, Simona Civollani2
1Nuclear Medicine, Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Current Oncology (Toronto, Ont.)
|January 24, 2025
Summary
Focal therapies like HIFU and brachytherapy show promise for localized prostate cancer. [68Ga]Ga-PSMA-11 PET/CT effectively detects recurrence after these treatments, improving patient surveillance.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Focal therapies, including high-intensity focused ultrasound (HIFU) and brachytherapy (BT), offer minimally invasive treatment for localized prostate cancer (PC).
- Current follow-up methods like biopsies and multiparametric MRI (mpMRI) have limitations in detecting treatment failures.
- Prostate-specific membrane antigen (PSMA) PET/CT imaging demonstrates high sensitivity and specificity for identifying residual or recurrent PC post-treatment.
Purpose of the Study:
- To evaluate the utility of [68Ga]Ga-PSMA-11 PET/CT in detecting biochemical recurrence (BCR) after focal therapy (HIFU or BT) for localized prostate cancer.
- To assess the detection rates and patterns of recurrence identified by PSMA PET/CT in patients previously treated with focal therapies.
Main Methods:
- Retrospective review of 22 patients who underwent [68Ga]Ga-PSMA-11 PET/CT for BCR after HIFU or BT between 2016 and 2024.
- Analysis of patient demographics, treatment history, time to PET scan, PSA levels, and PET/CT findings.
- Categorization of recurrence sites including prostate, lymph nodes, and metastatic disease.
Main Results:
- [68Ga]Ga-PSMA-11 PET/CT identified PC recurrence in 63.6% of patients.
- Recurrence patterns included prostate recurrence (50%), lymph node involvement (14%), and distant metastatic disease (28%).
- The median time from focal therapy to PET scan was 77 months, with a median PSA level of 3 ng/mL at the time of imaging.
Conclusions:
- Focal therapies (HIFU and BT) are viable options for localized prostate cancer, but effective surveillance is crucial.
- [68Ga]Ga-PSMA-11 PET/CT is a valuable tool for detecting recurrence or residual disease after focal therapy, surpassing traditional methods.
- Enhanced detection capabilities of PSMA PET/CT can guide further management and improve post-treatment surveillance strategies for prostate cancer patients.
