Indian Journal of Nuclear Medicine

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 32  |  Issue : 2  |  Page : 110--117

Clinical utility of gallium-68 PSMA PET/CT scan for prostate cancer


Kumaraswamy G Kallur1, Prashanth G Ramachandra1, Krishnappa Rajkumar1, Shivakumar S Swamy2, Indiresh Desai1, Raghavendra M Rao2, Shekhar Gowda Patil3, PS Sridhar4, Nagaraj Madhusudhan4, Raghunath S Krishnappa5, Veerendra Bhadrasetty6, Hemantha M Kumara6, SD Santhosh6, Basavalingaiah S Ajaikumar3 
1 Dept of Molecular Imaging, HCG Foundation, Bengaluru, India
2 Center for Academics and Research, HCG Foundation, Bengaluru, India
3 Dept of Medical Oncology, HCG Enterprises ltd, Bengaluru, India
4 Dept of Radiation Oncology, HCG Enterprises ltd, Bengaluru, India
5 Dept of Urooncology, HCG Enterprises ltd, Bengaluru, India
6 Dept of Radiopharmacy, HCG Enterprises ltd, Bengaluru, India

Correspondence Address:
Dr. Kumaraswamy G Kallur
Head, Dept of Molecular Imaging, P Kalinga Rao Rd, Sampangiramnagar, Bangalore
India

Background: Prostate cancer is biologically and clinically a heterogeneous disease that makes imaging evaluation challenging. One of the important challenges in this cancer is to detect recurrent disease. Biochemical response using Prostate Specific Antigen (PSA) and Imaging using several PET tracers have poor sensitivity and specificity. Therefore, we analyse the role of Ga68-PSMA (Prostate Specific Membrane Antigen) imaging in prostate cancer, which is a new PET tracer. Methods: In this study, we evaluated PET scans of 262 patients with diagnosis of prostate cancer. These patients were scanned using Ga68-PSMA for either staging or response evaluation. Results: 336 PSMA scans were performed. Ga68-PSMA scan resulted in the detection of extra-prostatic disease in 53.2% of cases when done at baseline before commencing any treatment. The sensitivity of Ga68-PSMA at baseline with histopathological diagnosis was 95% with 95% CI ranging from 86% to 98%. The positive predictive value was high at 98% with 95% CI ranging from 91% to 99%. In 26 (10%) patients who had surgical castration, Ga68-PSMA scan was able to detect disease progression / castration resistance in 100% of cases. The outcome of castration-resistant prostate cancer was compared with other cases where castration was not done. In those who did not undergo castration, there was a significantly better response by hormone therapy (p = 0.03) and radiotherapy (p = 0.01) on Ga68-PSMA. The sensitivity of Ga68-PSMA response with biochemical response was 66.7% with 95% CI ranging between 46 %- 82.7%. Ga68-PSMA response did not correlate with biochemical response. Conclusion: Ga68-PSMA has good sensitivity for diagnosis, staging, restaging, evaluation of therapy response and prognostication in prostate cancer.


How to cite this article:
Kallur KG, Ramachandra PG, Rajkumar K, Swamy SS, Desai I, Rao RM, Patil SG, Sridhar P S, Madhusudhan N, Krishnappa RS, Bhadrasetty V, Kumara HM, Santhosh S D, Ajaikumar BS. Clinical utility of gallium-68 PSMA PET/CT scan for prostate cancer.Indian J Nucl Med 2017;32:110-117


How to cite this URL:
Kallur KG, Ramachandra PG, Rajkumar K, Swamy SS, Desai I, Rao RM, Patil SG, Sridhar P S, Madhusudhan N, Krishnappa RS, Bhadrasetty V, Kumara HM, Santhosh S D, Ajaikumar BS. Clinical utility of gallium-68 PSMA PET/CT scan for prostate cancer. Indian J Nucl Med [serial online] 2017 [cited 2021 May 8 ];32:110-117
Available from: https://www.ijnm.in/article.asp?issn=0972-3919;year=2017;volume=32;issue=2;spage=110;epage=117;aulast=Kallur;type=0