Enhancing PSMA-uptake with androgen deprivation therapy – a new way to detect prostate cancer metastases?



Título del documento: Enhancing PSMA-uptake with androgen deprivation therapy – a new way to detect prostate cancer metastases?
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000434793
ISSN: 1677-5538
Autors: 1
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Institucions: 1University Medical Center Goettingen, Department of Urology, Goettingen, Weende. Alemania
2University Medical Center Goettingen, Department of Nuclear Medicine, Goettingen, Weende. Alemania
Any:
Període: May-Jun
Volum: 45
Número: 3
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Purpose: 68Ga-PSMA PET/CT imaging is a promising modality for the staging of recurrent prostate cancer (PCa). Current evidence suggests limited diagnostic value of the 68Ga-PSMA PET/CT in PSA-levels ≤0.3ng/mL. Experimental data have demonstrated an increase in PSMA-expression in PCa metastases by androgen deprivation in vitro. The aim of the current study was to investigate a possible enhancing effect of PSMA with low-dose androgen deprivation in patients with BCR and low PSA-levels. Materials and Methods: Five patients with PCa and BCR, following radical prostatectomy, underwent 68Ga-PSMA PET/CT. A consecutive 68Ga-PSMA PET/CT was performed 6 to 11 days after injection of 80mg of Degarelix (Firmagon®). We recorded PSA and testosterone serum-levels and changes of PSMA-uptake in 68Ga-PSMA PET/CT images. Results: Median PSA prior 68Ga-PSMA PET/CT was 0.27ng/mL. All patients had a decrease in testosterone serum levels from median 2.95μg/l to 0.16μg/l following Degarelix injection. We observed an increase in the standardized uptake value (SUV) in PSMA-positive lymphogenous and osseous lesions in two patients following androgen deprivation. In another two patients, no PSMA positive signals were detected in either the first or the second scan. Conclusion: Our preliminary results of this feasibility assessment indicate a possible enhancing effect of PSMA-imaging induced by low-dose ADT. Despite several limitations and the small number of patients, this could be a new approach to improve staging by 68Ga-PSMA PET/CT in PCa patients with BCR after primary therapy. Further prospective studies with larger number of patients are needed to validate our findings
Disciplines Medicina
Paraules clau: Urología,
Oncología,
Diagnóstico,
Neoplasias,
Próstata,
Radioterapia,
Metástasis,
Tomografía por emisión de positrones,
Imagenología por resonancia magnética
Keyword: Urology,
Oncology,
Diagnosis,
Neoplasms,
Prostate,
Radiotherapy,
Metastasis,
Positron emission tomography,
Magnetic resonance imaging
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