Prostate-specific membrane antigen (PSMA) is a cell surface protein with considerable overexpression on most prostate cancer cells.
68Ga-PSMA-PET is an emerging imaging modality that is highly sensitive and specific for detecting prostate cancer when compared to current standard imaging (CT,
MRI and bone scintigraphy).
Most published data has reported performance characteristics with little data on clinical utility,
especially in a regional setting.
Cairns Hospital is the largest major hospital in Far North Queensland.
Public patients suitable for PSMA-PET travel 1800 kilometers to The Royal Brisbane...
Methods and materials
We retrospectively reviewed all public patients investigated with 68Ga-PSMA-PET at the Cairns Hospital to determine the clinical utility.
Patient's case notes were examined to investigate the indications for scanning and to determine whether PSMA-PET imaging altered patient management.
62 patients were imaged with 68Ga-PSMA-PET-CT and 1 patient with whole body PSMA-PET-MRI between August 2015 to April 2017.
All decisions for imaging were undertaken at a multidisciplinary team level with all results subsequently reviewed at the meeting.Indications for imaging were primary staging (n=35) and investigation of biochemical recurrence (n=28).
For primary staging,
PSMA-PET was indicated when conventional staging imaging was inconclusive (n=16) or in patients at risk for metastases with normal conventional staging (n=19).
Of the 19 patients with normal conventional staging,
PSMA-PET is increasingly used for prostate cancer patient management.
In our cohort,
patients were imaged for primary staging or for investigation of biochemical recurrence.In selected patients,
PSMA-PET has significantly changed treatment options.
Despite the distance required to travel,
the judicious use of scanning in a regional urology unit is clinically useful for prostate cancer treatment decision making.
Ross Smith is currently a radiology registrar at the Sunshine Coast University Hospital.