Dados do Trabalho

Título

PSMA PET SCAN - INDICATIONS AND RATE OF CONDUCT CHANGE AFTER IMAGING

Introdução

Positron emission tomography (PET) using Prostate-specfic membrane antigen (PSMA) is a very sensitive method to detect prostate cancer tissue. PSMA is a transmembrane protein present in all prostatic tissues. Prostate adenocarcinomas have a high expression of PSMA in most lesions, both primary and metastatic. Therefore, 68Ga-PSMA-11 PET is a highly effective method to detect lesions deriving out of prostate adenocarcinomas.

Objetivo

This study aims to identify the principal indications for the use of PET PSMA,and to analyze the rate of conduct change after its result.

Método

We conducted a cohort retrospective study that analyses data from patients diagnosed with prostate cancer and were submitted to
PSMA PET SCAN at a oncological center in São Paulo – Brazil.

Resultado

Data from 57 patients subjected to PSMA PET scan were analyzed. Among them, 63,16% were indicated in a biochemical recurrence scenario, and 24,56% for staging. An exploratory analysis was done, among patients in biochemical recurrence, and metastatic disease was detected by PSMA PET Scan in 22,2% of the cases. There was not a variable that had a statistical significant association with the presence of metastatic disease or local recurrence. Neither Doubling Time nor pre-test PSA levels could predict or be associated with metastatic disease in biochemical recurrence scenario. Among patients in biochemical recurrence, a change of conduct in 47,2% of the cases occurred after PSMA PET Scan was done. There was no determining factor that could relate to metastatic disease in PSMA PET Scan. Perhaps the sample size did not allow the identification of other association factors.

Conclusão

PSMA PET Scan is a complex and high-cost exam that has a vast set of indications and can lead to conduct change in a large number of cases. In this retrospective study, the use of PET-PSMA allowed a change in oncologic conduct in 47.6% of patients with biochemical recurrence, allowing better targeting of surgical, radiotherapic and/or systemic oncological treatment. This support the best accuracy of this imaging method in this scenario.

Palavras-chave

PSMA, Prostate