| Title: |
Flourine-18 prostate-specific membrane antigen-1007 positron emission tomography imaging in staging of primary and secondary prostate cancer - a retrospective observational cohort study |
| Authors: |
Byrne, MHV; Ranasinha, N; Sharma, A; Mercader, C; Raslan, M; Sathanapally, G; Lewis, F; Gorgoraptis, S; Lopes Vieira, AC; Golebka, J; Peiris, B; Lopez, JF; Leslie, T; Bell, RC; Miah, S; Tuthill, M; Protheroe, A; Camilleri, P; Sabharwal, A; Andrade, G; Hamdy, FC; Macpherson, R; Gleeson, F; Bryant, RJ; Lamb, AD |
| Publisher Information: |
American Neurological Association |
| Publication Year: |
2026 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Background: Detection of metastatic disease is important to inform prostate cancer management. Objectives: Evaluate local and distant staging by initial 18F-PSMA-1007 PET in primary and secondary prostate cancer. Design, Setting, and Participants: We retrospectively identified a consecutive series of 18F-PSMA-1007 PET scans from the date of introduction of 18F-PSMA-1007 PET in September 2019 until April 2022 at a single UK tertiary referral center. Our protocol was registered in advance (OSF registration ID: KTE3R). Results: We identified 1335 PSMA-PET scans, from 1220 men. Across 623 initial scans for primary staging, we observed PSMA-PET avidity in 97.6% cases positive for local disease, 29.5% for nodal disease, and 26.5% for metastatic disease. PSMA-PET identified a 13.2% absolute increase in nodal lesions compared with MRI and a 24.0% absolute increase in metastatic lesions compared with MRI marrow. The sensitivity for detection of local disease among 79 patients who had radical prostatectomy was 96.2% for PSMA-PET vs 89.4% for multiparametric MRI. Across 612 scans for secondary staging, we observed PSMA-PET positive avidity in 51.2% of cases for local recurrence, 46.6% for nodal disease, and 43.0% for metastatic disease. When evaluated by the PSA range for patients receiving secondary staging, using the PSA values of 0.2 to 0.49, 0.5 to 0.99, 1 to 1.99, and ≥ 2 ng/mL, PSMA-PET scans were positive in 57.8%, 75.0%, 83.8%, and 95.5% of cases, respectively. PSMA-PET identified a 26.2% absolute increase in metastatic lesions compared with MRI marrow or other skeletal MRI (n = 61) and a 14.7% absolute increase in metastatic lesions compared with the bone scan (n = 42). Conclusion: 18F-PSMA-1007 PET identifies a higher number of nodal and metastatic lesions compared with conventional cross-sectional imaging. However, the high number of indeterminate lesions and stage migration necessitates discussion of 18F-PSMA-1007 PET imaging within a multidisciplinary team and places a higher burden on these teams. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1097/ju9.0000000000000206 |
| DOI: |
10.1097/ju9.0000000000000206 |
| Availability: |
https://doi.org/10.1097/ju9.0000000000000206; https://ora.ox.ac.uk/objects/uuid:798a3ae7-d8e7-49dd-bbb3-6dbe99a1f0b5 |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| Accession Number: |
edsbas.28242FCF |
| Database: |
BASE |