Evaluating the value of 18F-PSMA-1007 PET/CT in the detection and identification of prostate cancer using histopathology as the standard

Purpose Prostate-specific membrane antigen (PSMA) ligands targeting has shown promising results in staging of prostate cancer (PCa). The aim of present study was to evaluate the value of F-18-PSMA-1007 PET/CT in PCa patients with biochemical recurrence.Methods 71 patients with PCa after radical prostatectomy (RP) were included in the present study. Median prostate-specific antigen (PSA) level was 1.27 ng/mL (range 0.01-67.40 ng/mL, n = 69). All patients underwent whole-body PET/CT imaging after injection of 333 +/- 38 MBq F-18-PSMA-1007. The distribution of PSMA-positive lesions was assessed. The influence of PSA level, androgen deprivation therapy and primary Gleason score on PSMA-positive finding and uptake of F-18-PSMA-1007 were evaluated.Results 56 (79%) patients showed at least one pathological finding on F-18-PSMA-1007 PET/CT. The rates of positive scans were 50%, 80%, 100%, 100% among patients with PSA levels <= 0.5, 0.51-1.0, 1.1-2.0 and >2.0 ng/mL, respectively. The median Gleason score was 8 (range 7-10), and higher Gleason score (<= 7 vs. >= 8) leads to higher detection rates (58.3% (14/24) vs. 88.9% (32/36), P = 0.006). The median SUVmax of positive findings in patients with PSA levels <= 0.5, 0.51-1.0, 1.1-2.0 and >2.0 ng/mL were 4.51, 4.27, 11.50 and 14.08, respectively. The median SUVmax in patients with PSA level >2.0 ng/mL was significantly higher than that in patients with PSA <= 2.0 ng/mL (14.08 vs. 6.13, P<0.001).Conclusion F-18-PSMA-1007 PET/CT demonstrated a high detection rate for patients with a raised PSA level after radical prostatectomy even in patients with extremely low PSA level (eg. PSA level <= 0.5 ng/mL), which was essential for further clinical management for PCa patients.

Automated summary

The study evaluated the value of F-18-PSMA-1007 PET/CT in PCa patients after radical prostatectomy, and found that it showed a high detection rate even in patients with a raised PSA level. This finding is essential for further clinical management of PCa patients.