Ga-labeled Prostate-specific Membrane Antigen Ligand-positron-emission Tomography: Still Just the Tip of the Iceberg.
Urology
; 120: 187-191, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-29964126
ABSTRACT
OBJECTIVES:
To assess the performance of Ga-labeled prostate-specific membrane antigen ligand-positron-emission tomography (Ga-PSMA PET) for positive lymph nodes on imaging after curatively intended radical prostatectomy. PATIENTS ANDMETHODS:
Seventeen patients with biochemical recurrence after radical prostatectomy undergoing robot-assisted salvage lymphadenectomy for positive lymph nodes on imaging were included in this single surgeon study. The performance of Ga-PSMA PET was assessed on per patient, per lesion, per landing site and per laterality level using sensitivity, specificity, and negative and positive predictive value analysis.RESULTS:
A total of 34 positive nodes were detected on Ga-PSMA PET with a median of 2 nodes per patient (IQR 1-3 nodes per patient). Sixty six nodes were pathologically disease positive from 14 patients, with a median of 2 positive nodes per patient (IQR 1-6). Three patients had no pathologically detectable disease. On a per patient basis, the positive predictive value was 82%. Sensitivity, specificity, and negative predictive value were not able to be calculated as all patients had disease recurrence with a detectable prostate-specific antigen.On a "per lesion" basis, the sensitivity, specificity, positive predictive value, and negative predictive value were 36.7%, 96.9%, 73.5%, and 86.7%, respectively.CONCLUSION:
Our study indicates that sensitivity of Ga-PSMA PET in the salvage setting is not yet sufficient to detect all sites of metastasis. Therefore, imaging-guided metastasis targeted treatment is likely to fail given the likely concomitant imaging negative more widespread disease.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antígeno Prostático Específico
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Tomografia por Emissão de Pósitrons
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Radioisótopos de Gálio
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Linfonodos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Urology
Ano de publicação:
2018
Tipo de documento:
Article