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MP18-09: Influence of Ga-PSMA PET/CT on clinical decision making in the treatment of patients with prostate cancer.

Friday, May 12
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Carlos Ferreira*, Liliana Violante, Rui Freitas, Isaac Braga, Victor Silva, Sanches Magalhães, Francisco Lobo, António Morais, Hugo Duarte, Jorge Oliveira, Porto, Portugal

Introduction: Positron emission tomography (PET) with Ga-Prostate Specific Membrane Antigen (PSMA) is a new imagiological technique to stage patients with prostate cancer.
We aim to present the results of our preliminary analysis of 101 consecutive patients who performed this exam in our institution, exploring its utility in primary staging and re-staging after primary local treatment and its influence on clinical decision making.


Methods: From October 2015 to September 2016, 101 consecutive patients underwent Ga-PSMA PET/CT to stage patients before primary local treatment or, to detect recurrent or progressive disease after local treatment with curative intent in case of biochemical failure or persisting high PSA levels.
All the exams were performed and read by nuclear medicine doctors. After the exam, in a multidisciplinary meeting, urologists, oncologists and radioncologists decided the treatment strategy in management of the patient. The exam was judged "influent" if its results, positive or negative, supported or determined a modification in clinical strategy.




Results: Patients´characteristics are presented in table 1.
Globally, Ga-PSMA PET/CT detected at least one hypermetabolic lesion in 66/101 patients (65.3%).Detection rates were 23.3%, 33.3%, %, 41.2% and 91.1% for PSA-levels between 0.2-0.5, 0.5-1, >1-2 and >2, respectively.
Before the PET PSMA, 19 patients performed a pelvic MRI, 16 patients performed a bone scintigraphy, 7 patients a CT and 5 patients a PET-Choline exam.
The concordance rate for positive results of Ga-PSMA PET/CT was 80% for pelvic MRI, 57.2% for bone scintigraphy, 66.7% for CT and 25% for PET-Choline exam.
The main treatment influences of Ga-PSMA PET/CT on clinical decisions are presented in graphic 1. Decision-making was critically affected by PET-PSMA results in 81/101 (81.1%) patients.

Conclusions: We report our preliminary experience with Ga-PSMA PET/CT in primary staging and re-staging after primary local treatment. This exam influenced our clinical decisions in 81.2% of patients.

Source Of Funding: None

Carlos Ferreira, MD

Instituto de Ciências Biomédicas Abel Salazar

Carlos Ferreira, MD, 32 years-old, born in Braga and living in Porto, work in Unidade Local de Saúde de Matosinhos - Portugal as an Urologist Resident.
He did a Master in Medicine in "Instituto de Ciências Biomédicas Abel Salazar" from 2003-2009. In 2007, he studied 6 months in "Seconda Universitá di Napoli" under Erasmus programme.
He also performed a post-graduation in Health Management and Economy in 2010. He concluded is Residence Programme in Urology on April 2017.
He developed and published many researches related with minimally invasive procedures in Urology, like percutaneous nephrolithotomy, pelvic organ prolapse correction and artificial urinary sphincter implantation in women. Also, he is very interested in the concept of Theranostics as a way to guide doctors and surgeons to diagnose and treat precisely each patient. As an example, he is very interested in the potentials of prostate specific membrane antigen not only to stratify prostate cancer disease but also to explore the possibility of developing directed pharmacological or surgical treatments.

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MP18-09: Influence of Ga-PSMA PET/CT on clinical decision making in the treatment of patients with prostate cancer.



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