Positron emission tomography (PET) and computed tomography (CT) scans specific to prostate cancer can detect further disease and improve clinical management, according to recent research.
Ga68-Prostate Specific Membrane Antigen (PSMA) PET and CT scans are increasingly used to assess patients with prostate cancer. However, the impact of such scans in the clinical management of patients with prostate cancer has yet to be assessed.
Australian researchers led by Andrew Scott, AM, scientific director of positron emission tomography, department of medical imaging and therapy, Austin Health, conducted a prospective multicenter study to determine the impact of Ga68 PSMA PET and CT scans on clinical care in patients with such disease. A total of 431 patients were included who underwent pre- and post-Ga68 PSMA management plans with their primary care specialist between 2015 and 2016. Referring medical specialists completed a management intent survey prior to their patients undergoing Ga68 PSMA PET and CT scanning, followed by another survey after results of the scans were available. The primary question was to determine whether the management plan changed based on scan findings.
Ga68 PSMA PET and CT scans were performed for increasing prostate-specific antigen (PSA) after surgery or radiotherapy in 75% of patients and for primary staging in 25% of patients.
Results of the study were presented at the Society of Nuclear Medicine and Molecular Imaging 2017 Annual Meeting (June 10-14, 2017; Denver, CO).
Results of the surveys indicated that scan findings prompted changes in clinical management in approximately half (51%) of patients. Most significant changes in management occurred in patients with biochemical recurrence (64% after surgery, 69% after radiotherapy) compared with patients with primary staging (23%).
Additionally, preliminary analysis showed that PSMA scans detect disease that was not previously suspected in the prostate bed (30% of patients), locoregional lymph nodes (36% of patients), and distant disease (16% of patients).
These findings suggest that Ga68 PSMA PET and CT scans in prostate cancer can detect more disease and affect clinical management, especially in patients experiencing biochemical recurrence of disease after surgery or radiotherapy.—Zachary Bessette