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CC BY 4.0 · World J Nucl Med 2025; 24(02): 144-154
DOI: 10.1055/s-0045-1804894
Original Article

Detection Accuracy of [68Ga] PSMA PET/CT with Rising PSA in Prostate Cancer

Parul Mohan
1   Department of Nuclear Medicine, Mahajan Imaging and Labs, New Delhi, India
,
Palak Wadhwa
2   Central Research Institute, Shanghai United Imaging Healthcare, Shanghai, China
,
Harsh Mahajan
1   Department of Nuclear Medicine, Mahajan Imaging and Labs, New Delhi, India
,
Dileep Kumar
2   Central Research Institute, Shanghai United Imaging Healthcare, Shanghai, China
,
Giacomo Aringhieri
3   Department of Nuclear Medicine & PET/CT, University of Pisa, Pisa, Italy
,
Dania Cioni
3   Department of Nuclear Medicine & PET/CT, University of Pisa, Pisa, Italy
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Abstract

Objective The objective of this study was to evaluate the clinical utility of gallium-68 [68Ga] prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) with rising prostate-specific antigen (PSA) levels in prostate cancer diagnosis.

Methods This is a retrospective, single-center, observational cross-sectional study, which is provided after ethics committee clearance, from May 2, 2022 to June 25, 2022. Study includes sample size of 50 patients with prostate adenocarcinoma with varying PSA levels and Gleason score of 6 to 9 who underwent [68Ga] PSMA PET/CT scan. The patients included in this study underwent PET/CT scan on uMI550 (United Imaging Healthcare, Shanghai, China).

Results All patients were divided into three groups based on PSA levels in ng/mL as: PSA ≤ 0.2 (8%), 0.2 < PSA ≤ 1 (10%), 1 < PSA ≤ 3 (8%), 3 < PSA ≤ 10 (18%), and PSA > 10 (56%). Among 50 scans, at least one PSMA avid lesion was visualized in 41 scans (78.9%). These scans were considered positive and included in this study, rest of the scans had insignificant PSMA uptake and were considered negative. [68Ga] PSMA PET/CT detection rates were 75.0, 20.0, 50.0, 88.90, and 89.3% in patients with PSA ≤ 0.2, 0.2 < PSA ≤ 1, 1 < PSA ≤ 3, 3 < PSA ≤ 10, and PSA > 10, respectively. In addition to prostate bed, lesions were also visualized in lymph nodes (32%), liver (2%), skeleton (28%), and thorax (6%). Considering lesions in the prostate bed a significant direct correlation was detected between maximal standardized uptake value (SUVmax) and PSA value (p = 0.03).

Discussion PSMA PET/CT has been demonstrated to be an effective method for identifying both low-grade Gleason score tumors and low PSA levels. The study provides support for the use of [68Ga] PSMA PET/CT in conjunction with PSA levels for the evaluation of prostate cancer, including local recurrence and distant metastases.

Conclusion The findings of this study indicate that PSMA PET/CT is an effective method for diagnosing prostate cancer, as it allows for the detection of high SUVmax values in pathological tissues. Furthermore, high sensitivity and detection rates are noted with PSMA PET/CT scan even in cases where PSA levels were low. Therefore, this study demonstrates that [68Ga] PSMA PET/CT is beneficial for the early detection of prostate cancer and the prediction of treatment outcomes.

Keywords

PSA - PSMA PET/CT - digital PET/CT scanner - prostate cancer - prostate-specific antigen - molecular imaging - biomarkers

Authors' Contributions

All authors contributed to the study conception, design, material preparation, data collection, and analysis. All authors read and approved the final manuscript.


Data Availability

The data sets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


Ethical Approval

The studies involving human participants were reviewed and approved by the Institutional Review Board, Mahajan Imaging, Delhi, India. Informed consent was obtained from all individual participants included in the study (or the requirement for written consent was waived by the institutional review board). All procedures performed in studies involving human participants were in accordance with the Helsinki Declaration as revised in 2013 and its later amendments.


Declaration of Generative AI and AI-assisted Technologies in the Writing Process

During the preparation of this work the author(s) used ChatGPT to support writing the introduction section. After using this tool/service, the authors(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.




Publication History

Article published online:
27 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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