Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR)...Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.展开更多
In the past ^68Ge （Germanium-68） was purified with toxic organic solvents in liquid-liquid extractions making the product unacceptable by the FDA （food and drug Administration） for human use. The authors report in...In the past ^68Ge （Germanium-68） was purified with toxic organic solvents in liquid-liquid extractions making the product unacceptable by the FDA （food and drug Administration） for human use. The authors report initial studies utilizing three or four columns consisting of sequences of AG 1, AG50, Chelex 100 and/or Sephadex G25 resins. Five purification methods were examined and a separation consisting of the sequence： AG 1-Chelex100-Sephedex G25 provided 87% recovery of germanium. Fractionation of the elution resulted in high germanium concentrations.展开更多
基金supported in part by Varian, Paolo Alto, CA through a structured research agreementsupported by the National Medical Research Council Singapore Clinician-Scientist Award (Grant No. NMRC/CSA/0027/ 2018)the Duke-NUS Oncology Academic Program Proton Research Program
文摘Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.
文摘In the past ^68Ge （Germanium-68） was purified with toxic organic solvents in liquid-liquid extractions making the product unacceptable by the FDA （food and drug Administration） for human use. The authors report initial studies utilizing three or four columns consisting of sequences of AG 1, AG50, Chelex 100 and/or Sephadex G25 resins. Five purification methods were examined and a separation consisting of the sequence： AG 1-Chelex100-Sephedex G25 provided 87% recovery of germanium. Fractionation of the elution resulted in high germanium concentrations.
