PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item The effect of androgen deprivation therapy on Ga-68-PSMA tracer uptake in non-metastatic prostate cancer patients(2020) Onal, Cem; Guler, Ozan Cem; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0002-5597-676X; 0000-0001-8550-3368; 0000-0003-1715-4180; 0000-0001-6908-3412; 0000-0002-2742-9021; 31732768; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021; AAC-5654-2020; D-5195-2014Purpose To evaluate the effect of neoadjuvant androgen deprivation treatment (ADT) on prostate-specific membrane antigen (PSMA) tracer uptake demonstrated in Ga-68-PSMA-positron emission tomography (PET/CT) in non-metastatic hormone-naive prostate cancer (PC) patients. Materials and methods The clinical data of 108 PC patients who received neoadjuvant ADT were retrospectively analyzed. All patients had a baseline Ga-68-PSMA-PET/CT scan, and a second scan was delivered median of 2.9 months after the initiation of ADT. The maximum standardized uptake value (SUVmax) of primary tumor (SUVp) and metastatic lymph nodes (SUVln) as well as PSA response were assessed between pre- and post-ADT Ga-68-PSMA-PET/CT scans. Results There were significant decreases in posttreatment serum PSA, SUVp, and SUVln. A decrease in SUVp was seen in 91 patients (84%) with a median value of 66% (range, 5-100%), while 17 patients (16%) had no change in or an increase in PSMA tracer uptake with a median value of 24% (range, 0-198%). Patients with Gleason score (GS) of 7 had significantly higher metabolic response rates compared to other patients. The disease progression was significantly higher only in patients with GS > 7 disease compared to GS 7 disease. The PSA response to ADT was the lowest in patients with ISUP high-grade tumors. A total of 16 patients (15%) had progressive disease, and in 9 patients (8%), radiotherapy decisions were modified according to posttreatment Ga-68-PSMA-PET/CT scans. Conclusions The current study includes the largest number of patients analyzed to date and demonstrates that ADT causes a significant decrease in serum PSA values and SUVp and SUVln. The authors demonstrate that Ga-68-PSMA-PET/CT may be used as a quantitative imaging modality after neoadjuvant ADT in hormone-naive non-metastatic PC patients.Item Retrospective correlation of (68)ga-psma uptake with clinical parameters in prostate cancer patients undergoing definitive radiotherapy(2020) Onal, Cem; Torun, Nese; Oymak, Ezgi; Guler, Ozan C.; Reyhan, Mehmet; Yapar, Ali F.; 0000-0001-6908-3412; 0000-0001-8550-3368; 0000-0003-1715-4180; 0000-0002-2742-9021; 0000-0002-5597-676X; 32221791; AAC-5654-2020; AAJ-5242-2021; AAI-8973-2021; D-5195-2014; AAE-2718-2021Objective The aim of the study is to investigate the correlation between the intensity of prostate-specific membrane antigen (PSMA) uptake in primary tumor and clinico-pathological characteristics of non-metastatic prostate cancer patients treated with definitive radiotherapy (RT). Methods Using the clinical data of 201 prostate cancer patients who were referred for (68) Ga-PSMA-positron emission tomography (PET/CT) for staging and RT planning, we analyzed the correlations among intermediate- or high-risk disease based on Gleason score (GS), prostate-specific antigen (PSA) level, D'Amico risk group classification, and maximum standardized uptake (SUVmax) of primary tumor. Results Primary tumor was visualized via (68) Ga-PSMA-PET/CT scan in 192 patients (95.5%). The median SUVmax of primary tumor and metastatic lymph node were 13.2 (range 3.3-83.7) and 11.4 (range 3.6-64.5), respectively. A significant moderate correlation was observed between PSA level and median tumor SUVmax as measured by (68) Ga-PSMA-PET/CT (Spearman = 0.425; p < 0.001). Patients with serum PSA > 10 ng/mL, GS > 7, D'Amico high-risk group classification, and pelvic lymph node metastasis had significantly higher tracer uptake in primary tumor than their counterparts. The median SUVmax of primary tumor was highest in patients with GS 9. The primary tumor detection rates of (68) Ga-PSMA-PET/CT were 83%, 92%, and 99% for patients with serum PSA <= 5.0 ng/mL (14 patients, 7%), PSA 5.1-10.0 ng/mL (45 patients, 22%), and PSA > 10 ng/mL (142 patients, 71%), respectively. Conclusions We demonstrated a correlation between prostate tumor characteristics and PSMA tracer uptake. Patients with serum PSA > 10 ng/mL, GS > 7, D'Amico high-risk group classification, and pelvic lymph node metastasis had significantly higher SUV than their counterparts. In addition, the primary tumor detection rate was higher in patients with serum PSA > 10 ng/mL and GS > 7.Item Role of 68-Ga-PSMA-PET/CT in pelvic radiotherapy field definitions for lymph node coverage in prostate cancer patients(2020) Onal, Cem; Ozyigit, Gokhan; Guler, Ozan Cem; Hurmuz, Pervin; Torun, Nese; Tuncel, Murat; Dolek, Yemliha; Yedekci, Yagiz; Oymak, Ezgi; Tilki, Burak; Akyol, Fadil; 0000-0002-2742-9021; 0000-0001-6908-3412; 32861704; AAE-2718-2021; D-5195-2014; AAC-5654-2020Purpose: To evaluate the distribution of metastatic lymph nodes (LN) detected on Ga-68-PSMA-positron emission tomography/computed tomography (PET/CT) in treatment-naive prostate cancer (PC) patients and to analyze the LN coverage rates of the pelvic fields defined in the GETUG trial and RTOG guidelines and a pelvic field extending superiorly from the L4/L5 interspace. Materials and methods: Ga-68-PSMA-PET/CT images obtained at diagnosis of 138 PC patients were retro-spectively analyzed. The number and locations of Ga-68-PSMA-positive LNs were co-registered with one single-planning CT. The numbers, locations, and sizes of LNs located outside the three pelvic volumes were investigated for the entire cohort and for patients with LN metastasis in the pelvic area only. Results: A total of 441 PSMA-PET-positive LN metastases were identified. The most frequent metastatic LNs were internal iliac LNs (25.2%). Para-aortic and presacral LNs outside the three pelvic fields were present in 20 (14.5%) and 22 patients (15.9%), respectively. The LN coverage rates according to the GETUG trial, the RTOG guidelines, and the pelvic field extending superiorly from L4/L5 were 44.2%, 52.2%, and 71, respectively, in the entire cohort and 51.7%, 61 and 83.1%, respectively, in patients with only pelvic LN metastasis. The number of metastatic LNs was a predictive factor for LNs located outside the three pelvic fields. Conclusions: Extending the cranial margin of the pelvic field from L5/S1 to L4/L5 increases the accuracy of pelvic field irradiation in approximately 20% of patients, highlighting the importance of proximal common iliac irradiation, particularly in patients with multiple LN metastasis. (C) 2020 Elsevier B.V. All rights reserved.