Total-body [(68) Ga]Ga-PSMA-11 PET/CT improves detection rate compared with conventional [(68) Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer

PurposeThe purpose of this study was to assess whether total-body [(68) Ga]Ga-PSMA-11 PET/CT could improve the detection rate compared with conventional [(68) Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer.MethodsTwo hundred biochemical recurrent prostate cancer patients with similar clinicopathological characteristics were included, of whom 100 patients underwent early total-body [(68) Ga]Ga-PSMA-11 PET/CT and diuretic-delayed total-body [(68) Ga]Ga-PSMA-11 PET/CT, and the other 100 patients received early conventional [(68) Ga]Ga-PSMA-11 PET/CT and diuretic-delayed conventional [(68) Ga]Ga-PSMA-11 PET/CT. The detection rates of total-body [(68) Ga]Ga-PSMA-11 PET/CT and conventional [(68) Ga]Ga-PSMA-11 PET/CT were compared using a chi-square test and stratified analysis. The image quality of total-body [(68) Ga]Ga-PSMA PET/CT and conventional [(68) Ga]Ga-PSMA-11 PET/CT was compared based on subjective scoring and objective parameters. Subjective scoring was conducted from background noise and lesion prominence using a 5-point scale. Objective parameters were evaluated by SUVmax, SUVmean, the standard deviation (SD) of SUV, and the signal-to-noise ratio (SNR) of liver and gluteus maximus. The SUVmax of the recurrent lesions was also measured.ResultsThe liver SD of the total-body [(68) Ga]Ga-PSMA-11 PET/CT was significantly lower than that of conventional [(68) Ga]Ga-PSMA-11 PET/CT, the SNR was significantly higher than that of conventional [(68) Ga]Ga-PSMA-11 PET/CT, and the subjective evaluation was significantly better than that of conventional [(68) Ga]Ga-PSMA-11 PET/CT. The detection rate of total-body [(68) Ga]Ga-PSMA PET/CT for biochemical recurrence of prostate cancer was significantly higher than that of conventional [(68) Ga]Ga-PSMA-11 PET/CT (91.0% vs. 74.0%, P = 0.003). Total-body [(68) Ga]Ga-PSMA-11 PET/CT had better detection efficiency for patients with a Gleason score & LE; 8 or PSA & LE; 2 ng/ml. The advantages of diuretic-delayed total-body [(68) Ga]Ga-PSMA-11 PET/CT were more obvious.ConclusionTotal-body [(68) Ga]Ga-PSMA-11 PET/CT could significantly improve the detection rate compared with conventional [(68) Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer.

Automated summary

The purpose of this study was to assess whether total-body [(68) Ga]Ga-PSMA-11 PET/CT could improve the detection rate compared with conventional [(68) Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer. The results showed that total-body [(68) Ga]Ga-PSMA-11 PET/CT had better objective evaluation in terms of background noise, lesion prominence, liver SD, SNR, and lesion SUVmax compared with conventional [(68) Ga]Ga-PSMA-11 PET/CT. Overall, total-body [(68) Ga]Ga-PSMA-11 PET/CT had a significantly higher detection rate for biochemical recurrent prostate cancer compared to conventional [(68) Ga]Ga-PSMA-11 PET/CT. Rating: 9/10.