Value of 18F-PSMA PET/MRI for early diagnosis of recurrence and metastasis in prostate cancer patients after radical prostatectomy

Abstract

Objective: To investigate the value and significance of 18F-prostate-specific membrane antigen (18F-PSMA)-1007 PET/MR for early diagnosis of recurrence and metastasis in prostate cancer patients after radical prostatectomy (RP). Methods: A total of 143 patients with prostate cancer after radical prostatectomy were enrolled during June 2019 to January 2022 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. All the patients underwent 18F-PSMA-1007 PET/MR imaging within 12 to 60 months after surgery. According to the serum prostate-specific antigen (PSA) levels, patients were divided into 5 groups（PSA≤0.2 ng/mL, 0.2 ng/mL<PSA≤0.5 ng/mL, 0.5 ng/mL<PSA≤4.0 ng/mL, 4.0 ng/mL<PSA<10.0 ng/mL and PSA≥10.0 ng/mL). The detection rates of recurrence or metastasis were compared between different groups. Results: The detection rates of 18F-PSMA-1007 PET/MR for recurrence or metastasis in PSA≤0.2 ng/mL, 0.2 ng/mL<PSA≤0.5 ng/mL, 0.5 ng/mL< PSA ≤ 4.0 ng/mL, 4.0 ng/mL<PSA<10.0 ng/mL and PSA ≥ 10.0 ng/mL groups were 25.00% (6/24)，70.00% (7/10)，66.67% (16/24)，74.07% (20/27) and 94.83% (55/58) respectively, and bilateral comparison between groups revealed that difference in detection rate was statistically significant (P<0.01 or P<0.05). In terms of treatment，34 patients (27.64%) changed their pre-examination treatment regimen based on the results of 18F-PSMA-1007 PET/MR imaging. Conclusions: It reveals that prostate patients with detected recurrence or metastasis account for 25% of those with normal PSA level.The detection rate increases with the increase of PSA levels. It suggests that 18F-PSMA PET/MR can detect recurrence and metastasis in the early stage, which can effectively guide the formulation of treatment plans.

Keywords

• |positron emission tomography computed tomography|magnetic resonance imaging|prostate cancer