CT-PET PSMA has recently been approved to more accurately detect the extent of prostate cancer. Here we examined PSA level and kinetics (PSA doubling time-PSADT) as a predictor of positive up-take in patients evaluated for suspected recurrent disease.
We retrospectively collected data on 99 patients evaluated by CT-PET PSMA. Mann-Whitney U test and student's T Test (SPSS 20) were applied to test for differences in median in PSA and PSADT level, Pearson test was used for correlation analysis. PSADT was calculated by Memorial Sloan Kettering Cancer Center calculator of 3 recent levels.
Ninety nine patients underwent CT-PET PSMA. Their median age was 71 (52-94) years. Uptake was detected in 84 (84.8%) patients; 51 (51.5%) patients with metastatic disease (lymph nodes, bones, visceral) and 33 (33.3%) patients with only localized disease (prostate, prostatic bed after prostatectomy). Median Gleason 8 (6-10), median PSA 4.66 (0.12-272) ng/ml. CT-PET was positive in 57.1%, 88.9% and 96.8% of patients with PSA levels of ≤ 1, >1-2 and >2 ng/ml, respectively, and 91.7%, 90.5% and 81.8% of patients with PSADT ≤2, >2-6 and > 6 months, respectively. Only median PSA levels were significantly associated with any uptake: 5.90 ± 35.71 vs. 0.35 ± 4.18 ng/ml, p
The decision to perform CT-PET PSMA in prostate cancer patients suspected to have recurrent or metastatic disease should be based on PSA levels. PSADT is a significant marker for positive metastatic CT-PET PSMA uptake.
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All authors have declared no conflicts of interest.