M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda
{"title":"前列腺癌根治性前列腺切除术后PSA低于1 ng/mL诊断为前列腺癌患者的F-PSMA PET/CT阴性研究对补救性放疗预后的临床价值[18F]。","authors":"M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda","doi":"10.1016/j.remnie.2025.500071","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess the clinical value of [<sup>18</sup>F]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.</div></div><div><h3>Method</h3><div>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 [<sup>18</sup>F]F-PSMA -PET/CT study.</div><div>The [<sup>18</sup>F]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.</div></div><div><h3>Results</h3><div>54.7% (29/53) of the patients with a negative [<sup>18</sup>F]F-PSMA -PET/CT underwent PSRT.</div><div>Of these, 93.1% (27/29) patients demonstrated response to treatment (PSMA false negatives).</div><div>The remaining two patients showed fluctuating PSA levels without detecting disease on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study.</div><div>45.3% (24/53) of patients with negative [<sup>18</sup>F]F-PSMA -PET/CT did not undergo PSRT.</div><div>Of these, progressive PSA elevation was observed in 62.5% (15/24) (PSMA false negatives), localising recurrence on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study in 4 patients.</div><div>The remaining 9 patients (37.5%) showed fluctuating PSA levels without detecting disease on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study.</div><div>Our series confirmed 42 (42.85%) [<sup>18</sup>F]F-PSMA -PET/CT false negatives cases.</div></div><div><h3>Conclusion</h3><div>Patients diagnosed with prostate cancer with post-prostatectomy biochemical recurrence and a negative [<sup>18</sup>F]F-PSMA -PET/CT study are likely to benefit from pelvic salvage radiotherapy, with response seen in 93.1% of our cases.</div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 2","pages":"Article 500071"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical value of a negative [18F]F-PSMA PET/CT study in patients diagnosed with prostate cancer treated with prostatectomy with PSA rising below 1 ng/mL after radical prostatectomy, on the outcome of salvage radiotherapy\",\"authors\":\"M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda\",\"doi\":\"10.1016/j.remnie.2025.500071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To assess the clinical value of [<sup>18</sup>F]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.</div></div><div><h3>Method</h3><div>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 [<sup>18</sup>F]F-PSMA -PET/CT study.</div><div>The [<sup>18</sup>F]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.</div></div><div><h3>Results</h3><div>54.7% (29/53) of the patients with a negative [<sup>18</sup>F]F-PSMA -PET/CT underwent PSRT.</div><div>Of these, 93.1% (27/29) patients demonstrated response to treatment (PSMA false negatives).</div><div>The remaining two patients showed fluctuating PSA levels without detecting disease on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study.</div><div>45.3% (24/53) of patients with negative [<sup>18</sup>F]F-PSMA -PET/CT did not undergo PSRT.</div><div>Of these, progressive PSA elevation was observed in 62.5% (15/24) (PSMA false negatives), localising recurrence on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study in 4 patients.</div><div>The remaining 9 patients (37.5%) showed fluctuating PSA levels without detecting disease on the [<sup>18</sup>F]F-PSMA -PET/CT follow-up study.</div><div>Our series confirmed 42 (42.85%) [<sup>18</sup>F]F-PSMA -PET/CT false negatives cases.</div></div><div><h3>Conclusion</h3><div>Patients diagnosed with prostate cancer with post-prostatectomy biochemical recurrence and a negative [<sup>18</sup>F]F-PSMA -PET/CT study are likely to benefit from pelvic salvage radiotherapy, with response seen in 93.1% of our cases.</div></div>\",\"PeriodicalId\":94197,\"journal\":{\"name\":\"Revista espanola de medicina nuclear e imagen molecular\",\"volume\":\"44 2\",\"pages\":\"Article 500071\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista espanola de medicina nuclear e imagen molecular\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2253808925000102\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista espanola de medicina nuclear e imagen molecular","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2253808925000102","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical value of a negative [18F]F-PSMA PET/CT study in patients diagnosed with prostate cancer treated with prostatectomy with PSA rising below 1 ng/mL after radical prostatectomy, on the outcome of salvage radiotherapy
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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