Underestimation of Positron Emission Tomography/Computerized Tomography in Assessing Tumor Burden in Prostate Cancer Nodal Recurrence: Head-to-Head Comparison of <sup>68</sup> Ga-PSMA and <sup>11</sup> C-Choline in a Large, Multi-Institutional Series of Extended Salvage Lymph Node Dissections
Nicola Fossati, Simone Scarcella, Giorgio Gandaglia, Nazareno Suardi, Daniele Robesti, Luca Boeri, R. Jeffrey Karnes, Axel Heidenreich, David Pfister, Alexander Kretschmer, Alexander Büchner, Christian G. Stief, Antonino Battaglia, Steven Joniau, Hendrik Van Poppel, Daniar Osmonov, Klaus‐Peter Juenemann, Shahrokh F. Shariat, Andreas Hiester, Alessandro Nini, Peter Albers, Derya Tilki, Markus Graefen, Inderbir S. Gill, Alexandre Mottrie, Andrea Benedetto Galosi, Francesco Montorsi, Alberto Briganti
Abstract
PURPOSE: Ga-prostate specific membrane antigen in men undergoing salvage lymph node dissection for nodal recurrent prostate cancer. MATERIALS AND METHODS: Ga-PSMA) and tumor burden underestimation. RESULTS: Ga-PSMA only when prostate specific antigen was 1.5 ng/ml or less. Conversely, the underestimation of the 2 tracers became similar when prostate specific antigen was greater than 1.5 ng/ml. Furthermore, we evaluated the risk of underestimation by number of positive spots on positron emission tomography/computerized tomography. The higher the number of positive spots the higher the underestimation of tumor burden regardless of the tracer used (p=0.2). CONCLUSIONS: C-choline in assessing the extent of nodal recurrence.