Comparative Performance of <sup>68</sup>Ga-PSMA-11 PET/CT and Conventional Imaging in the Primary Staging of High-Risk Prostate Cancer Patients Who Are Candidates for Radical Prostatectomy
Guido Rovera,
Serena Grimaldi,
Marco Oderda,
Giancarlo Marra,
Giorgio Calleris,
Giuseppe Carlo Iorio,
Marta Falco,
Cristiano Grossi,
Roberto Passera,
Giuseppe Campidonico,
Maria Luce Mangia,
Désirée Deandreis,
Riccardo Faletti,
Umberto Ricardi,
Paolo Gontero,
Silvia Morbelli
Affiliations
Guido Rovera
Nuclear Medicine Division, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
Serena Grimaldi
Nuclear Medicine Division, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy
Marco Oderda
Urology Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, 10126 Turin, Italy
Giancarlo Marra
Urology Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, 10126 Turin, Italy
Giorgio Calleris
Urology Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, 10126 Turin, Italy
Giuseppe Carlo Iorio
Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy
Marta Falco
Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy
Cristiano Grossi
Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy
Roberto Passera
Nuclear Medicine Division, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
Giuseppe Campidonico
Nuclear Medicine Division, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy
Maria Luce Mangia
Nuclear Medicine Division, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy
Désirée Deandreis
Nuclear Medicine Division, Gustave Roussy, 94805 Villejuif, France
Riccardo Faletti
Radiology Unit, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
Umberto Ricardi
Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy
Paolo Gontero
Urology Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, 10126 Turin, Italy
Silvia Morbelli
Nuclear Medicine Division, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
This prospective study aimed to (1) compare the diagnostic performance of 68Ga-PSMA-11 PET/CT with respect to conventional imaging (computed tomography (CT) and bone scintigraphy (BS)) in the primary staging of high-risk prostate cancer (PCa) patients and (2) validate PSMA-PET/CT accuracy in pelvic nodal staging in comparison with postoperative histopathology and assess PSMA-PET/CT’s impact on patient management. Sixty castration-sensitive high-risk (ISUP 4–5 and/or PSA > 20 ng/mL and/or cT3) PCa patients eligible for radical prostatectomy were enrolled (median PSA 10.10 [IQR: 6.22–17.95] ng/mL). PSMA-PET/CT, compared with CT, identified nodal (N) and/or distant metastases (M1) in 56.7% (34/60) vs. 13.3% (8/60) (p p p = 0.03), M1b 23.3% vs. 1.7% (p n = 32 patients), the per-patient accuracy of PSMA-PET/TC for detecting pelvic nodal metastases was 90.6%. Overall, the above evidence supports the use of PSMA-PET/CT in the diagnostic workup of high-risk prostate cancer staging.
