December 2018 - Bernhard Grubmüller

Dr. Bernhard Grubmüller

MedUni Wien RESEARCHER OF THE MONTH Dezember 2018   

68Ga-PSMA 11 ligand PET imaging in patients with biochemical recurrence after radical prostatectomy - diagnostic performance and impact on therapeutic decision-making

The aim of the study was to evaluate the diagnostic performance of [⁶⁸Ga]Ga-PSMA^HBED-CC conjugate 11 positron emission tomography (PSMA-PET) in the early detection of metastases in patients with biochemical recurrence (BCR) after radical prostatectomy (RP), to compare it to CT/MRI alone and to assess its impact on further therapeutic decisions. 117 consecutive hormone naïve BCR patients were assessed retrospectively, with a median PSA level at the time of imaging of 1.04 ng/ml. PSMA-PET showed excellent detection rates in this setting (65% to 100% for PSA levels between 0.2 and 2.0 ng/ml). A verification of the PSMA-PET positive lesions with a reputable standard of reference was available in 79%. PSMA-PET changed therapeutic decisions in 74.6% of the patients, with 86% of them being considered for metastases-directed therapies. Therefore we could show, that PSMA-PET adds significant information to standard imaging, changing treatment strategies in a significant number of patients.

Selected Literature

1. Grubmüller B, Shariat SF, Hartenbach M et al. 68Ga-PSMA 11 ligand PET imaging in patients with biochemical recurrence after radical prostatectomy - diagnostic performance and impact on therapeutic decision-making. Eur J Nucl Med Mol Imaging. 2018;45:235-242.
2. Kane CJ, Kane CJ, Amling CL, et al. Limited value of bone scintigraphy and computed tomography in assessing biochemical failure after radical prostatectomy. Urology. 2003;61(3):607-611.
3. Eiber M, Maurer T, Souvatzoglou M, et al. Evaluation of Hybrid ⁶⁸Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2015;56(5):668-674. doi:10.2967/jnumed.115.154153.
4. Klatte T, Grubmüller B, Waldert M, Weibl P, Remzi M. Laparoscopic cryoablation versus partial nephrectomy for the treatment of small renal masses: systematic review and cumulative analysis of observational studies. Eur Urol 2011;60:435-43.
5. Grubmüller B, Baltzer P, Hartenbach S, et al. PSMA ligand PET/MRI for primary prostate cancer: Staging performance and clinical impact. Clin Cancer Res. 2018 Aug 23. pii: clincanres.0768.2018. doi: 10.1158/1078-0432.CCR-18-0768. [Epub ahead of print].
6. Grubmüller B, Baum RP, Capasso E, et al. 64Cu-PSMA-617 PET/CT Imaging of Prostate Adenocarcinoma: First In-Human Studies. Cancer Biother Radiopharm. 2016 Oct.7 (Epub ahead of print).
7. Grubmüller B, Senn D, Kramer G, et al. Response assessment using 68Ga-PSMA ligand PET in patients undergoing 177Lu-PSMA radioligand therapy for metastatic castration resistant prostate cancer. Eur J Nucl Med Mol Imaging. (In Revision)