Timing van de PSMA PET/CT-scan bij biochemisch recidief na radicale prostatectomie

We created a model predicting the probability to detect prostate cancer recurrence outside the prostatic fossa in men with biochemical recurrence (BCR) after radical prostatectomy (RP). 419 patients with BCR (prostate specific antigen [PSA] < 2.0 ng/ml) after RP without hormone therapy underwent a ⁶⁸Ga-Prostate Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computer Tomograpy (PET/CT)-scan. Predictors for the detection of prostate cancer recurrence outside the prostatic fossa were identified using multivariable logistic regression analysis. At a median PSA of 0,40 ng/ml (interquartile range 0,30–0,70), PSMA PET/CT detected prostate cancer recurrence outside the prostatic fossa in 174 (42%) patients. Significant predictors for the detection of prostate cancer recurrence outside the prostatic fossa were PSA value at time of scanning and RP specimen characteristics Gleason-score, lymph node status and surgical margin status. PSA value at time of scanning and RP specimen characteristics, Gleason-score, lymph node status and surgical margin status are all important predictors for the probability to detect prostate cancer recurrence outside the prostatic fossa. The dashboard (https://psma.prostatecancer-riskcalculator.com/) can be used to determine the clinical most optimal moment to perform a PSMA PET/CT scan.