[F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels

Background: Prostate cancer (PCa) patients with biochemical recurrence (BCR) following radical prostatectomy or radiation therapy often present with very low prostate-specific antigen (PSA) levels (⩽0.5 ng/mL). Accurate detection of recurrence at such low levels is crucial for guiding treatment deci...

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Main Authors: Ko-Han Lin, Tzu-Chun Wei, Shu-Huei Shen, William Ji-Shien Huang, Mei-Hua Chuang, Nan-Jing Peng, Wen-Tao Huang, Yuh-Feng Wang
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Biomarker Insights
Online Access:https://doi.org/10.1177/11772719251324307
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author Ko-Han Lin
Tzu-Chun Wei
Shu-Huei Shen
William Ji-Shien Huang
Mei-Hua Chuang
Nan-Jing Peng
Wen-Tao Huang
Yuh-Feng Wang
author_facet Ko-Han Lin
Tzu-Chun Wei
Shu-Huei Shen
William Ji-Shien Huang
Mei-Hua Chuang
Nan-Jing Peng
Wen-Tao Huang
Yuh-Feng Wang
author_sort Ko-Han Lin
collection DOAJ
description Background: Prostate cancer (PCa) patients with biochemical recurrence (BCR) following radical prostatectomy or radiation therapy often present with very low prostate-specific antigen (PSA) levels (⩽0.5 ng/mL). Accurate detection of recurrence at such low levels is crucial for guiding treatment decisions. Objectives: To assess the diagnostic efficacy of [ 18 F]PSMA-1007 PET/MR (PSMA-PETMR) in detecting BCR of PCa in patients with very low PSA levels. Design: A prospective study conducted between May 2021 and January 2023, with data subsequently analyzed retrospectively after a 2-year follow-up. Methods: The cohort comprised 157 PCa patients with BCR, of whom 52 had PSA levels ⩽ 0.5 ng/mL and underwent PSMA-PETMR imaging. The imaging protocol incorporated multiparametric MRI (mpMRI) and PET acquisitions, with lesion classification following PSMA-RADS version 1.0. Detection rates of recurrent lesions, including local recurrence, lymph node metastasis, and skeletal metastasis, were evaluated. Results: PSMA-PETMR exhibited a 63.5% detection rate for recurrent PCa at low PSA levels, surpassing traditional diagnostic methods. Thirty-four local recurrences, 12 metastatic lymph nodes, and 4 skeletal metastases were identified. Follow-up imaging enhanced the detection rate to 73.1% by reclassifying initially equivocal findings. PSMA-PETMR influenced clinical decision-making in 17% of patients by facilitating personalized treatment strategies. Conclusion: PSMA-PETMR significantly improves the detection of recurrent PCa in patients with very low PSA levels, offering precise lesion localization and supporting personalized treatment approaches. Further studies are needed to optimize its clinical use and validate its long-term benefits.
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spelling doaj-art-2b8ca94ce88842e1bf780a26d55765fb2025-08-20T02:06:16ZengSAGE PublishingBiomarker Insights1177-27192025-03-012010.1177/11772719251324307[F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA LevelsKo-Han Lin0Tzu-Chun Wei1Shu-Huei Shen2William Ji-Shien Huang3Mei-Hua Chuang4Nan-Jing Peng5Wen-Tao Huang6Yuh-Feng Wang7Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, TaiwanMacKay Junior College of Medicine, Nursing, and Management, New Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, TaiwanDepartment of Biomedical Imaging and Radiological Sciences, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, TaiwanBackground: Prostate cancer (PCa) patients with biochemical recurrence (BCR) following radical prostatectomy or radiation therapy often present with very low prostate-specific antigen (PSA) levels (⩽0.5 ng/mL). Accurate detection of recurrence at such low levels is crucial for guiding treatment decisions. Objectives: To assess the diagnostic efficacy of [ 18 F]PSMA-1007 PET/MR (PSMA-PETMR) in detecting BCR of PCa in patients with very low PSA levels. Design: A prospective study conducted between May 2021 and January 2023, with data subsequently analyzed retrospectively after a 2-year follow-up. Methods: The cohort comprised 157 PCa patients with BCR, of whom 52 had PSA levels ⩽ 0.5 ng/mL and underwent PSMA-PETMR imaging. The imaging protocol incorporated multiparametric MRI (mpMRI) and PET acquisitions, with lesion classification following PSMA-RADS version 1.0. Detection rates of recurrent lesions, including local recurrence, lymph node metastasis, and skeletal metastasis, were evaluated. Results: PSMA-PETMR exhibited a 63.5% detection rate for recurrent PCa at low PSA levels, surpassing traditional diagnostic methods. Thirty-four local recurrences, 12 metastatic lymph nodes, and 4 skeletal metastases were identified. Follow-up imaging enhanced the detection rate to 73.1% by reclassifying initially equivocal findings. PSMA-PETMR influenced clinical decision-making in 17% of patients by facilitating personalized treatment strategies. Conclusion: PSMA-PETMR significantly improves the detection of recurrent PCa in patients with very low PSA levels, offering precise lesion localization and supporting personalized treatment approaches. Further studies are needed to optimize its clinical use and validate its long-term benefits.https://doi.org/10.1177/11772719251324307
spellingShingle Ko-Han Lin
Tzu-Chun Wei
Shu-Huei Shen
William Ji-Shien Huang
Mei-Hua Chuang
Nan-Jing Peng
Wen-Tao Huang
Yuh-Feng Wang
[F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
Biomarker Insights
title [F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
title_full [F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
title_fullStr [F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
title_full_unstemmed [F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
title_short [F]PSMA-1007 PET/MR as a Precision Biomarker for Early Detection of Biochemical Recurrence in Prostate Cancer at Very Low PSA Levels
title_sort f psma 1007 pet mr as a precision biomarker for early detection of biochemical recurrence in prostate cancer at very low psa levels
url https://doi.org/10.1177/11772719251324307
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