Consensus Statements on PSMA PET/CT Response Assessment Criteria in Prostate Cancer

Stefano Fanti, Karolien Goffin, Boris A Hadaschik, Ken Herrmann, Tobias Maurer, Steven MacLennan, Daniela E. Oprea-Lage, Wim JG Oyen, Olivier Rouvière, Nicolas Mottet, Anders Bjartell* (Corresponding Author)

*Corresponding author for this work

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Abstract

Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology and/or urology met on February 21, 2020 in Amsterdam, The Netherlands, to formulate criteria for PSMA PET/CT-based response in patients treated for metastatic PCa and optimal timing to use it.

Methods: Panelists received thematic topics and relevant literature prior to the meeting. Statements on how to interpret response and progression on therapy in PCa with PSMA PET/CT and when to use it were developed. Panelists voted anonymously on a nine-point scale, ranging from strongly disagree (1) to strongly agree (9). Median scores described agreement and consensus.

Results: PSMA PET/CT consensus statements concerned utility, best timing for performing, criteria for evaluation of response, patients who could benefit, and handling of radiolabeled PSMA PET tracers. Consensus was reached on all statements. PSMA PET/CT can be used before and after any local and
systemic treatment in patients with metastatic disease to evaluate response to treatment. Ideally, PSMA PET/CT imaging criteria should categorize patients as responders, patients with stable disease, partial response, and complete response, or as non-responders. Specific clinical scenarios such as oligometastatic or polymetastatic disease deserve special consideration.

Conclusions: Adoption of PSMA PET/CT should be supported by indication for appropriate use and precise criteria for interpretation. PSMA PET/CT criteria should categorize patients as responders or nonresponders. Specific clinical scenarios deserve special consideration.
Original languageEnglish
Pages (from-to)469–476
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume48
Issue number2
Early online date2 Jul 2020
DOIs
Publication statusPublished - Feb 2021

Bibliographical note

Funding The one-day EAU / EANM PSMA PET/CT Response Assessment Criteria meeting received an unrestricted grant from Janssen, and no influences on the content of the meeting or on the publication.
Acknowledgements The authors acknowledge John William Bean PhD (Bean Medical Writing, Halle, Belgium and funded by EAU Research Foundation) for providing medical writing services and Wim Witjes MD PhD (Scientific and Clinical Research Director EAU Research Foundation) and Emily Spieker (Management Assistant, European Association of Urology) for project management.

Keywords

  • Monitoring
  • Oligometastatic Prostate Cancer
  • PERCIST
  • Polymetastatic Prostate Cancer
  • Prostate Cancer
  • Prostate-Specific Membrane Antigen (PSMA)
  • PSMA Ligand
  • RECIST
  • PET/CT

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