Comparison Between 64Cu-PSMA-617 PET/CT and 18F-Choline PET/CT Imaging in Early Diagnosis of Prostate Cancer Biochemical Recurrence

Francesco Cantiello, Fabio Crocerossa, Giorgio Ivan Russo, Vincenzo Gangemi, Matteo Ferro, Mihai Dorin Vartolomei, Giuseppe Lucarelli, Maria Mirabelli, Chiara Scafuro, Giuseppe Ucciero, Ottavio De Cobelli, Giuseppe Morgia, Rocco Damiano, Giuseppe Lucio Cascini

Research output: Contribution to journalArticlepeer-review

Abstract

In the clinical setting of biochemical recurrence after radical prostatectomy, current guidelines do not recommend the use of choline-based positron emission tomography (PET) with computed tomography (CT) with prostate-specific antigen (PSA) < 1 ng/mL. 64Cu-PSMA-617 PET/CT performed better than 18F-choline PET/CT in prostate cancer restaging, with a detection rate of 57.1% versus 14.3% in the 0.2-0.5 ng/mL PSA subgroup. Purpose: To evaluate the diagnostic performance of 64Cu-PSMA-617 positron emission tomography (PET) with computed tomography (CT) for restaging prostate cancer after biochemical recurrence (BCR) and to compare it with 18F-choline PET/CT in a per-patient analysis. Patients and Methods: An observational study was performed of 43 patients with BCR after laparoscopic radical prostatectomy who underwent 64Cu-PSMA-617 PET/CT and subsequently 18F-choline PET/CT for restaging. The detection rates (DR) of 64Cu-PSMA-617 PET/CT and of 18F-choline PET/CT were calculated by standardized maximum uptake value (SUVmax) at 4 hours and SUVmax at 1 hour as reference, respectively. Furthermore, univariate logistic regression analysis was carried out to identify independent predictive factors of positivity with 64Cu-PSMA-617 PET/CT. Results: An overall positivity with 64Cu-PSMA-617 PET/CT was found in 32 patients (74.4%) versus 19 (44.2%) with 18F-choline PET/CT. Specifically, after stratifying for prostate-specific antigen (PSA) values, we found a good performance of 64Cu-PSMA-617 PET/CT at low PSA levels compared to 18F-choline PET/CT, with a DR of 57.1% versus 14.3% for PSA 0.2-0.5 ng/mL (P =.031), and of 60% versus 30% with PSA 0.5-1 ng/mL. At univariate binary logistic regression analysis, PSA level was the only independent predictor of 64Cu-PSMA-617 PET/CT positivity. No significant difference in terms of DR for both 64Cu-PSMA-617 PET/CT and 18F-choline PET/CT was found according to different Gleason score subgroups. Conclusion: In our study cohort, a better performance was observed for 64Cu-PSMA-617 PET/CT compared to 18F-choline PET/CT in restaging after BCR, especially in patients with low PSA values.

Original languageEnglish
Pages (from-to)385-391
Number of pages7
JournalClinical Genitourinary Cancer
Volume16
Issue number5
DOIs
Publication statusPublished - Oct 1 2018

Keywords

  • Positron emission tomography/computed tomography
  • Prostate-specific membrane antigen
  • Radical prostatectomy
  • Restaging

ASJC Scopus subject areas

  • Oncology
  • Urology

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