The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer

被引:654
作者
Afshar-Oromieh, Ali [1 ,2 ]
Avtzi, Eleni [1 ]
Giesel, Frederik L. [1 ,2 ]
Holland-Letz, Tim [3 ]
Linhart, Heinz G. [4 ]
Eder, Matthias [5 ]
Eisenhut, Michael [5 ]
Boxler, Silvan [6 ]
Hadaschik, Boris A. [6 ]
Kratochwil, Clemens [1 ,2 ]
Weichert, Wilko [7 ]
Kopka, Klaus [5 ]
Debus, Juergen [8 ]
Haberkorn, Uwe [1 ,2 ]
机构
[1] Univ Heidelberg Hosp, Dept Nucl Med, D-69120 Heidelberg, Germany
[2] German Canc Res Ctr, Clin Cooperat Unit Nucl Med, D-69120 Heidelberg, Germany
[3] German Canc Res Ctr, Dept Biostat, D-69120 Heidelberg, Germany
[4] German Canc Res Ctr, Natl Ctr Tumor Dis NCT, D-69120 Heidelberg, Germany
[5] German Canc Res Ctr, Div Radiopharmaceut Chem, D-69120 Heidelberg, Germany
[6] Univ Heidelberg Hosp, Dept Urol, D-69120 Heidelberg, Germany
[7] Univ Heidelberg Hosp, Dept Pathol, D-69120 Heidelberg, Germany
[8] Univ Heidelberg Hosp, Dept Radiat Oncol & Therapy, D-69120 Heidelberg, Germany
关键词
Prostate cancer; PET/CT; Positron emission tomography; PSMA; FMCH; FECH; MEMBRANE ANTIGEN-EXPRESSION; ANDROGEN RECEPTOR; PRIMARY TUMOR; ADENOCARCINOMA; TOMOGRAPHY; INHIBITOR; THERAPY; PET/MRI; BIOPSY; TARGET;
D O I
10.1007/s00259-014-2949-6
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose Since the introduction of positron emission tomography (PET) imaging with Ga-68-PSMA-HBED-CC (-(68)GaDKFZ-PSMA-11), this method has been regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). However, published data exist for small patient cohorts only. The aim of this evaluation was to analyse the diagnostic value of Ga-68-PSMA-ligand PET/CT in a large cohort and the influence of several possibly interacting variables. Methods We performed a retrospective analysis in 319 patients who underwent Ga-68-PSMA-ligand PET/CT from 2011 to 2014. Potential influences of several factors such as prostate-specific antigen (PSA) level and doubling time (DT), Gleason score (GSC), androgen deprivation therapy ADT), age and amount of injected tracer were evaluated. Histological verification was performed in 42 patients after the Ga-68-PSMA-ligand PET/CT. Tracer uptake was measured in 901 representative tumour lesions. Results In 82.8 % of the patients at least one lesion indicative of PCa was detected. Tumor-detection was positively associated with PSA level and ADT. GSC and PSA-DT were not associated with tumor-detection. The average maximum standardized uptake value (SUVmax) of tumour lesionswas 13.3 +/- 14.6 (0.7-122.5). Amongst lesions investigated by histology, 30 were false-negative in 4 different patients, and all other lesions (n=416) were true-positive or true-negative. A lesion-based analysis of sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) revealed values of 76.6 %, 100 %, 91.4 % and 100 %. A patientbased analysis revealed a sensitivity of 88.1 %. Of 116 patients available for follow-up, 50 received local therapy after Ga-68-PSMA-ligand PET/CT. Conclusion Ga-68-PSMA-ligand PET/CT can detect recurrent PCa in a high number of patients. In addition, the radiotracer is highly specific for PCa. Tumour detection is positively associated with PSA and ADT. Ga-68-PSMA-ligand PET/CT can help delay systemic therapy of PCa.
引用
收藏
页码:197 / 209
页数:13
相关论文
共 37 条
[1]   Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labelled PSMA ligand for the diagnosis of recurrent prostate cancer: initial experience [J].
Afshar-Oromieh, A. ;
Haberkorn, U. ;
Schlemmer, H. P. ;
Fenchel, M. ;
Eder, M. ;
Eisenhut, M. ;
Hadaschik, B. A. ;
Kopp-Schneider, A. ;
Roethke, M. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2014, 41 (05) :887-897
[2]   PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions [J].
Afshar-Oromieh, A. ;
Malcher, A. ;
Eder, M. ;
Eisenhut, M. ;
Linhart, H. G. ;
Hadaschik, B. A. ;
Holland-Letz, T. ;
Giesel, F. L. ;
Kratochwil, C. ;
Haufe, S. ;
Haberkorn, U. ;
Zechmann, C. M. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2013, 40 (04) :486-495
[3]   [68Ga]Gallium-labelled PSMA ligand as superior PET tracer for the diagnosis of prostate cancer: comparison with 18F-FECH [J].
Afshar-Oromieh, A. ;
Haberkorn, U. ;
Eder, M. ;
Eisenhut, M. ;
Zechmann, C. M. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2012, 39 (06) :1085-1086
[4]   Comparison of PET imaging with a 68Ga-labelled PSMA ligand and 18F-choline-based PET/CT for the diagnosis of recurrent prostate cancer [J].
Afshar-Oromieh, Ali ;
Zechmann, Christian M. ;
Malcher, Anna ;
Eder, Matthias ;
Eisenhut, Michael ;
Linhart, Heinz G. ;
Holland-Letz, Tim ;
Hadaschik, Boris A. ;
Giesel, Frederik L. ;
Debus, Juergen ;
Haberkorn, Uwe .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2014, 41 (01) :11-20
[5]   PET/MRI with a 68Ga-PSMA ligand for the detection of prostate cancer [J].
Afshar-Oromieh, Ali ;
Haberkorn, Uwe ;
Hadaschik, Boris ;
Habl, Gregor ;
Eder, Matthias ;
Eisenhut, Michael ;
Schlemmer, Heinz-Peter ;
Roethke, Matthias C. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2013, 40 (10) :1629-1630
[6]   EAU guidelines on prostate cancer [J].
Aus, G ;
Abbou, CC ;
Bolla, M ;
Heidenreich, A ;
Schmid, HP ;
van Poppel, H ;
Wolff, J ;
Zattoni, F .
EUROPEAN UROLOGY, 2005, 48 (04) :546-551
[7]   Technology Insight: monoclonal antibody imaging of prostate cancer [J].
Bander, NH .
NATURE CLINICAL PRACTICE UROLOGY, 2006, 3 (04) :216-225
[8]  
Benesova M, 2013, EUR J NUCL MED MOL I, V40, pS281
[9]   2-(3-{1-Carboxy-5-[(6-[18F]Fluoro-Pyridine-3-Carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid, [18F]DCFPyL, a PSMA-Based PET Imaging Agent for Prostate Cancer [J].
Chen, Ying ;
Pullambhatla, Mrudula ;
Foss, Catherine A. ;
Byun, Youngjoo ;
Nimmagadda, Sridhar ;
Senthamizhchelvan, Srinivasan ;
Sgouros, George ;
Mease, Ronnie C. ;
Pomper, Martin G. .
CLINICAL CANCER RESEARCH, 2011, 17 (24) :7645-7653
[10]   PSMA as a target for radiolabelled small molecules [J].
Eder, Matthias ;
Eisenhut, Michael ;
Babich, John ;
Haberkorn, Uwe .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2013, 40 (06) :819-823