To evaluate the role of the 68Ga-PSMA in the staging and

management of the Prostatic Cancer in various clinical

scenarios.

Sikandar M Shaikh,

DMRD,DNB,EDiR,MNAMS

Hyderabad,

Telangana

INDIA

idrsikandar@gmail.com

PURPOSE

Prostate cancer is one of the commonest biologically and clinically a

heterogeneous disease in males which has varied diagnostic

challenges.

The biggest challenge in this is to detect recurrent disease.

Biochemical response using Prostate Specific Antigen (PSA) and

various imaging modalities including F FDG PET-CT has limited role

as most of them have poor sensitivity and specificity.

Thus we evaluated the role of Ga68-PSMA (Prostate Specific

Membrane Antigen) imaging in prostate cancer, which is a new PET

tracer.

MATERIAL AND METHODS

We evaluated Ga68-PSMA PET scans of 65 patients with

diagnosed prostate cancer.

Whole body PET-CT was done after injecting Ga68-PSMA for

either staging or re staging to evaluate the response to therapy.

RESULTS

65 PSMA scans were performed initially .

Ga68-PSMA scan showed more number of areas involved by extra-prostatic

disease in 53.2% of cases when done at baseline before commencing any

treatment.

The sensitivity of Ga68-PSMA at baseline when compared with histopathological

diagnosis was 95% with 95% CI ranging from 86% to 98%.

The positive predictive value was high at 98% with 95% CI ranging from 91% to

99%.

In 7 (12%) patients who underwent surgical management post therapy

Ga68-PSMA scan was able to detect disease progression / post surgical

relapse in 100% of cases.

The outcome of post surgical prostate cancer was compared with other

cases where surgery was not done.

In those who did not surgery due to higher staging these cases showed

better response by hormone therapy (p 61; 0.03) and radiotherapy (p 61;

0.01) on Ga68-PSMA.

The sensitivity of Ga68-PSMA response with biochemical response was

66.7% with 95% CI ranging between 46 %- 82.7%.

Ga68-PSMA response did not correlate with biochemical response.

CASE 1

64 Years old

Diagnosed Prostatic cancer

Gleason score 6

CASE 2

Post Radical Prostatectomy

Follow up case

Extensive recurrence

Contd case 2

CASE 3

63 years old Post operative

Post chemotherapy

Follow up

CASE 4 Diagnosed case. Gleeson score 8

CASE 5

CASE 6 Extensive skeletal metastases

CASE 7 Post radiotherapy recurrence

CONCLUSION

Thus Ga68-PSMA has very good sensitivity for diagnosis, staging,

restaging, evaluation of therapy response and prognostication in

prostate cancer

CLINICAL RELEVANCE/APPLICATION

Thus PET-CT PSMA has very high sensitivity as compared with

F FDG PET-CT

THANK YOU FOR YOUR KIND ATTENTION

idrsikandar@gmail.com