68 Ga-PSMA-11 Positron Emission Tomography Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study

Purpose:PSA persistence after radical prostatectomy is associated with adverse outcome in patients with prostate cancer. We aimed to define regions at risk for residual disease as well as the accuracy of PSMA-ligand PET in patients with PSA persistence.Materials and Methods:From 6 participating centers, 191 patients with 68Ga-PSMA-11 PET scan (PET/CT or PET/MRI) for persistently elevated post-operative PSA levels (≥0.1 ng/mL) were retrospectively included. Detection rate and positive-predictive value were determined. In patients with additional PSMA-ligand PET before prostatectomy (n=33), rate of PET-based persistence and recurrence was determined.Results:PSMA-ligand PET localized PCa-lesions in 68% (130 of 191) patients with PSA persistence at a median PSA level of 1.1 ng/mL. Detection rate significantly increased with the PSA (p<0.001). Regarding PSMA PET/CT only, 35% (61 of 173) patients had disease confined to the pelvis while 33% (57 of 173) of patients had distant lesions. Most frequently affected n...