68Ga-PSMA PET-CT and PSMA score affecting therapeutic decision-making in high-risk prostatic carcinoma

Purpose:
This research study was conducted to evaluate the impact of (⁶⁸Ga)-tagged prostatic-specific membrane antigen (⁶⁸Ga-PSMA) positron emission tomography and computed tomography (PET-CT), compare its role with conventional radiology in early staging of high-risk prostate cancer, and calculate the PSMA score evaluating its usefulness in ⁶⁸Ga-PSMA PET-CT reporting in our patient population.

Material and methods:
⁶⁸Ga-PSMA PET-CT of 65 high-risk cases of prostate cancer was performed for staging purpo­ses. Any change in disease stage was noted after ⁶⁸Ga-PSMA PET-CT findings and PSMA score leading to a change in the management plan.

Results:
Change in disease stage post-PSMA imaging was seen in 39% cases, high PSMA score (03) was noted in > 80% of upstaged cases, while low score (0) and (1) was seen in 65% and 35% down-staged individuals, respectively. Change in therapeutic decision-making was observed in 32% (21) of patients.

Conclusions:
⁶⁸Ga-PSMA PET-CT scans have a significant influence on the planned clinical management of high-risk prostate cancer patients; hence, they can be utilized as a replacement for radiological imaging tools, particularly in the detection of pelvic nodal and distant metastatic disease. PSMA score can be considered as an effective tool in standardized reporting of ⁶⁸Ga-PSMA imaging.