Valor clínico de un PET/TC con [18F]F-PSMA negativo en pacientes diagnosticados de cáncer de próstata tratados con prostatectomía con elevación del PSA, inferior a 1 ng/ml, en los resultados de la radioterapia de rescate

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2025-03-01 DOI:10.1016/j.remn.2024.500071

M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda

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Abstract

Objective

To assess the clinical value of [¹⁸F]F-PSMA negative PET/CT, in patients diagnosed with prostate cancer treated with prostatectomy with elevated PSA less than 1 ng/mL, on the outcome of salvage radiotherapy.

Method

We prospectively included 98 patients diagnosed with prostate cancer treated with prostatectomy with biochemical recurrence [mean PSA 0.51 ng/mL (range 0.17-1,0 ng/mL)] who were referred for an [¹⁸F]F-PSMA-PET/CT study.

The [¹⁸F]F-PSMA-PET/CT scan was negative in 53/98 patients (54.09%). Differences were analysed between those patients who were or were not candidates for pelvic salvage radiotherapy (PSRT) decided upon multidisciplinary committee and patient consent, with a minimum follow-up time for 1 year. Response to treatment was defined as a 50% reduction in PSA levels. Recurrence was ascertained upon clinical, analytical and imaging follow-up outcomes.

Results

54.7% (29/53) of the patients with a negative [¹⁸F]F-PSMA-PET/CT underwent PSRT. Of these, 93.1% (27/29) patients demonstrated response to treatment (PSMA false negatives). The remaining two patients showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA-PET/CT follow-up study.

45.3% (24/53) of patients with negative [¹⁸F]F-PSMA-PET/CT did not undergo PSRT. Of these, progressive PSA elevation was observed in 62.5% (15/24) (PSMA false negatives), localising recurrence on the [¹⁸F]F-PSMA-PET/CT follow-up study in 4 patients. The remaining 9 patients (37.5%) showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA-PET/CT follow-up study.

Our series confirmed 42 (42.85%) [¹⁸F]F-PSMA-PET/CT false negatives cases.

Conclusion

Patients diagnosed with prostate cancer with post-prostatectomy biochemical recurrence and a negative [¹⁸F]F-PSMA-PET/CT study are likely to benefit from pelvic salvage radiotherapy, with response seen in 93.1% of our cases.

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.