68Ga-PSMA PET/CT for the detection of bone metastasis in recurrent prostate cancer and a PSA level <2 ng/ml: Two case reports and a literature review

Lars J Petersen; Julie B Nielsen; Katja Dettmann; Rune V Fisker; Uwe Haberkorn; Louise Stenholt; Helle D Zacho

doi:10.3892/mco.2017.1280

⁶⁸Ga-PSMA PET/CT for the detection of bone metastasis in recurrent prostate cancer and a PSA level <2 ng/ml: Two case reports and a literature review

Mol Clin Oncol. 2017 Jul;7(1):67-72. doi: 10.3892/mco.2017.1280. Epub 2017 May 31.

Authors

Lars J Petersen^{1

2}, Julie B Nielsen^{1

2}, Katja Dettmann³, Rune V Fisker^{1

4}, Uwe Haberkorn^{5

6}, Louise Stenholt⁷, Helle D Zacho^{1

2}

Affiliations

¹ Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, DK-9000 Aalborg, Denmark.
² Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark.
³ Department of Urology, Regional Hospital West Jutland, DK-7500 Holstebro, Denmark.
⁴ Department of Radiology, Clinical Cancer Research Center, Aalborg University Hospital, DK-9000 Aalborg, Denmark.
⁵ Department of Nuclear Medicine, University Hospital of Heidelberg, D-69120 Heidelberg, Germany.
⁶ Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Centre, D-69120 Heidelberg, Germany.
⁷ The Medical Library, Aalborg University Hospital, DK-9000 Aalborg, Denmark.

Abstract

Localization of prostate cancer recurrence, particularly in the bones, is a major challenge with standard of care imaging in patients with biochemical recurrence following curatively intended treatment. Gallium-68-labeled prostate specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga-PSMA PET/CT) is a novel and promising method for imaging in prostate cancer. The present study reports two cases of patients with prostate cancer with biochemical recurrence, with evidence of bone metastases on ⁶⁸Ga-PSMA PET/CT images and low prostate specific antigen PSA levels (<2 ng/ml) and PSA doubling time >6 months. The bone metastases were verified by supplementary imaging with ¹⁸F-sodium fluoride PET/CT and magnetic resonance imaging as well as biochemical responses to androgen deprivation therapy. Therefore, ⁶⁸Ga-PSMA PET/CT is promising for the restaging of patients with prostate cancer with biochemical recurrence, including patients with low PSA levels and low PSA kinetics.

Keywords: 68Ga-prostate-specific membrane antigen; biochemical recurrence; positron emission tomography; prostate-specific antigen; prostate-specific antigen kinetics.