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Enhancing PSMA-uptake with androgen deprivation therapy - a new way to detect prostate cancer metastases?
Int. braz. j. urol; 45(3): 459-467, May-June 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1012312
Biblioteca responsável: BR1.1
ABSTRACT

ABSTRACT PURPOSE:

68Ga-PSMA PET/CT imaging is a promising modality for the staging of recurrent prostate cancer (PCa). Current evidence suggests limited diagnostic value of the 68Ga-PSMA PET/CT in PSA-levels ≤0.3ng/mL. Experimental data have demonstrated an increase in PSMA-expression in PCa metastases by androgen deprivation in vitro. The aim of the current study was to investigate a possible enhancing effect of PSMA with low-dose androgen deprivation in patients with BCR and low PSA-levels.

MATERIALS AND METHODS:

Five patients with PCa and BCR, following radical prostatectomy, underwent 68Ga-PSMA PET/CT. A consecutive 68Ga-PSMA PET/CT was performed 6 to 11 days after injection of 80mg of Degarelix (Firmagon®). We recorded PSA and testosterone serum-levels and changes of PSMA-uptake in 68Ga-PSMA PET/CT images.

RESULTS:

Median PSA prior 68Ga-PSMA PET/CT was 0.27ng/mL. All patients had a decrease in testosterone serum levels from median 2.95μg/l to 0.16μg/l following Degarelix injection. We observed an increase in the standardized uptake value (SUV) in PSMA-positive lymphogenous and osseous lesions in two patients following androgen deprivation. In another two patients, no PSMA positive signals were detected in either the first or the second scan.

CONCLUSION:

Our preliminary results of this feasibility assessment indicate a possible enhancing effect of PSMA-imaging induced by low-dose ADT. Despite several limitations and the small number of patients, this could be a new approach to improve staging by 68Ga-PSMA PET/CT in PCa patients with BCR after primary therapy. Further prospective studies with larger number of patients are needed to validate our findings.

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Alemanha Instituição/País de afiliação: University Medical Center Goettingen/DE