Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01

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Impact of Ga-PSMA PET/CT in the treatment of prostate cancer: Initial experience in Spain

Felipe Couñago123, Claudio Martínez-Ballesteros4, Carlos Artigas5, Ana Aurora Díaz-Gavela123, Luis Leonardo Gómez12, María Eugenia Lillo-García6, José Reinaldo Chicharo6, Manuel Recio7, Antonio Maldonado8, Israel J. Thuissard9, Cristina Andreu-Vázquez10, David Sanz-Rosa3, Antonio José Conde-Moreno11, Francisco José Marcos123, Sofía Sánchez García12, Juan Ignacio Martínez-Salamanca4, Joaquin Carballido-Rodríguez4, Javier Hornedo12, Elia del Cerro123
DOI: 10.1016/j.rpor.2020.03.024
Rep Pract Oncol Radiother 2020;25(3):405-411.

Abstract

Aim

To evaluate whether positron-emission tomography/computed tomography with 68Ga-PSMA (68Ga-PSMA PET/CT) influences the therapeutic management of patients with primary or recurrent prostate cancer (PCa).

Background

Although 68Ga-PSMA PET/CT is one of the best options for staging or restaging patients with PCa, its availability is still very limited in Spain. The present study reports the results of the first group of patients in Spain who underwent 68Ga-PSMA PET/CT imaging.

Materials and methods

All patients (n = 27) with a histological diagnosis of PCa who underwent 68Ga-PSMA PET/CT prior to the definitive treatment decision at the only centre with this technology in Spain during 2017–2018 were included. Two nuclear medicine physicians and a radiologist reviewed the imaging studies. The clinical impact was assessed from a theoretical perspective, based on the treatment that would have been applied if no data from the 68Ga-PSMA PET/CT were available.

Results

Most patients (n = 26; 96%) had persistent disease or biochemical recurrence after radical prostatectomy, radiotherapy, or combined treatment. One patient underwent 68Ga-PSMA PET/CT imaging to stage high-risk PCa. Overall, 68Ga-PSMA PET/CT was positive in 19 patients (70.4%). In 68.75% of these patients, none of the other imaging tests—MRI, CT, or bone scans—performed prior to the 68Ga-PSMA PET/CT were able to detect the presence of cancerous lesions. Overall, the findings of the 68Ga-PSMA PET/CT led to a modification of the therapeutic approach in 62.96% of the patients in the study.

Conclusions

68Ga-PSMA PET/CT alters the therapeutic approach in a substantial proportion of patients with PCa.

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