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Title:

[PSMA-radioguided surgery in localized recurrent prostate cancer : Current and future aspects].

Document type:
Journal Article; Review; Article
Author(s):
Rauscher, I; Eiber, M; Jilg, C A; Gschwend, J E; Maurer, T
Abstract:
Recently, PSMA-radioguided surgery (PSMA-RGS) was introduced for targeted resection of localized prostate cancer recurrence. Prerequisite for preoperative patient selection and localization of tumor recurrence is a positive Ga-HBED-CC PSMA positron emission tomography (PET) scan with preferably only singular soft tissue or lymph node recurrence. After injection of In-PSMA I&T or Tc-PSMA-I&S single photon emission computer tomography (SPECT)/computer tomography (CT) examination is performed in every patient to verify radiotracer uptake in tumor lesions. In a preliminary study, In-PSMA I&T SPECT/CT could detect about half of the Ga-HBED-CC PSMA PET-positive lesions, while nearly all PET-positive lesions could be detected using PSMA-RGS and also five additional lesions compared to Ga-HBED-CC-PSMA PET. Follow-up data from 55 patients show a PSA reduction >50% and >90% in 44 (80%) and 29 (53%) patients, respectively. In 34 (62%) patients, a PSA drop to <0.2 ng/ml was observed. In all, 15 (27%) patients received further PC-specific treatment; the remaining 40 (73%) patients did not undergo further treatment. In 33% of patients, surgery-related complications were noted; however, most were regarded as minor. Thus, PSMA-RGS seems to be of high value in patients with localized prostate cancer recurrence with exact localization and resection of metastatic tissue. However, patient selection based on Ga-PSMA PET imaging and clinical parameters is crucial to obtain satisfactory oncological results.
Journal title abbreviation:
Urologe A
Year:
2017
Journal volume:
56
Journal issue:
1
Pages contribution:
18-23
Language:
de
Fulltext / DOI:
doi:10.1007/s00120-016-0275-2
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/27885455
Print-ISSN:
0340-2592
TUM Institution:
Klinik und Poliklinik für Nuklearmedizin; Urologische Klinik und Poliklinik
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