Restaging the Biochemical Recurrence of Prostate Cancer with [⁶⁸Ga]Ga-PSMA-11 PET/CT: Diagnostic Performance and Impact on Patient Disease Management

• Main Authors: Aloÿse Fourquet, Lucien Lahmi, Timofei Rusu, Yazid Belkacemi, Gilles Créhange, Alexandre de la Taille, Georges Fournier, Olivier Cussenot, Mathieu Gauthé
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Cancers
• Subjects: prostatic neoplasms; positron-emission tomography; decision making
• Online Access: https://www.mdpi.com/2072-6694/13/7/1594

Background: Detection rates of [⁶⁸Ga]Ga-PSMA-11 PET/CT on the restaging of prostate cancer (PCa) patients presenting with biochemical recurrence (BCR) have been well documented, but its performance and impact on patient management have not been evaluated as extensively. Methods: Retrospective analysis of PCa patients presenting with BCR and referred for [⁶⁸Ga]Ga-PSMA-11 PET/CT. Pathological foci were classified according to six anatomical sites and evaluated with a three-point scale according to the uptake intensity. The impact of [⁶⁸Ga]Ga-PSMA-11 PET/CT was defined as any change in management that was triggered by [⁶⁸Ga]Ga-PSMA-11 PET/CT. The existence of a PCa lesion was established according to a composite standard of truth based on all clinical data available collected during the follow-up period. Results: We included 294 patients. The detection rate was 69%. Per-patient sensitivity and specificity were both 70%. Patient disease management was changed in 68% of patients, and [⁶⁸Ga]Ga-PSMA-11 PET/CT impacted this change in 86% of patients. The treatment carried out on patient was considered effective in 89% of patients when guided by [⁶⁸Ga]Ga-PSMA-11 PET/CT versus 61% of patients when not guided by [⁶⁸Ga]Ga-PSMA-11 PET/CT (<i>p</i> < 0.001). Conclusions: [⁶⁸Ga]Ga-PSMA-11 PET/CT demonstrated high performance in locating PCa recurrence sites and impacted therapeutic management in nearly two out of three patients.