Impact of reduced scan extent on tumor detection in ⁶⁸Ga-PSMA PET/CT for biochemical recurrence of prostate cancer.
- 1University Hospital Jena, Clinic of Nuclear Medicine, Am Klinikum 1, 07747, Jena, Germany.
- 2University Hospital Jena, Clinic of Nuclear Medicine, Am Klinikum 1, 07747, Jena, Germany. [email protected].
Abstract
Background
PSMA PET/CT plays an important role in biochemically recurrent prostate cancer (BCR-PCa). In general, PET/CT is performed as a limited or true whole-body examination. The majority of PET/CT scanners operate by measuring several bed positions or continuous motion with a limited axial field of view (FOV). Shortening the scan area thus results in a time saving, with unknown information loss regarding the detection of tumor manifestations.Methodology
This retrospective single-center study included 200 patients with BCR-PCa after initial curative therapy who underwent a ⁶⁸Ga-PSMA-PET/CT scan from vertex to toe (true whole-body). Using retrospective subdivision into hypothetical partial body measurement protocols, the undetected tumor manifestations were examined. Classic PET/CT protocols were used: vertex to mid-thigh, skull base to mid-thigh, as well as CT-equivalent examination areas: chest/abdomen/pelvis (CAP), abdomen/pelvis (AP) and pelvis.Results
Of 200 patients with a median PSA of 1.1 ng/mL, 128 (64%) showed at least one structural correlate of BCR-PCa in the true whole-body scan. The overall detection rate did not change for limited classic PET-protocols, or CAP measurements. CAP scans would not have detected all tumor manifestations in 16 patients (8%) and not all tumor-affected organ systems in six patients (3%), AP scans in 41 patients (21%) and 18 patients (9%), pelvic scans in 61 patients (31%) and 37 patients (19%), respectively. PSA may contribute to the prospective restriction of the scan area. Patients with PSA ≤ 0.75 ng/mL showed no diagnostic gain from whole-body imaging. This means that in 45% of patients in our cohort, a limitation to CAP scan would have been possible without losing information.Conclusions
For a resource-saving use of routine PSMA-PET/CT, a scan from the vertex to the mid-thigh seems sufficient for detecting relevant metastases. For patients with low PSA levels, a more focused protocol that includes only the CAP region can be considered.
Related
- Clinical impact of PSMA PET/CT on the management of biochemical recurrence in prostate cancer.
- High lesion detection rates with preoperative ⁹⁹ᵐTc-PSMA-SPECT/CT prior to radioguided surgery in biochemical recurrence: a hypothesis-generating analysis of quantitative PSMA-PET/CT parameters.
- Prognostic value of postoperative dynamic PNI trajectories for biochemical recurrence in patients with high-risk localized prostate cancer: a longitudinal trajectory clustering study.
- Clinicopathologic Predictors of PSMA-PET Detection, Recurrence Pattern, and Biochemical Outcome Following Salvage Radiotherapy After Radical Prostatectomy
- Pathomic Texture Composites from H&E, and Immunohistochemistry of Prostatectomy Specimens for Exploratory Modeling of Time to Biochemical Recurrence
BibTeX
@article{guhne2026impact,
title = {{Impact of reduced scan extent on tumor detection in ⁶⁸Ga-PSMA PET/CT for biochemical recurrence of prostate cancer.}},
author = {Falk Gühne and Alexander Küppers and Christian Kühnel and Philipp Seifert and Martin Freesmeyer},
journal = {BMC medical imaging},
year = {2026},
month = oct,
doi = {10.1186/s12880-026-02940-w},
url = {https://europepmc.org/article/MED/42907742},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of reduced scan extent on tumor detection in ⁶⁸Ga-PSMA PET/CT for biochemical recurrence of prostate cancer.
AU - Falk Gühne
AU - Alexander Küppers
AU - Christian Kühnel
AU - Philipp Seifert
AU - Martin Freesmeyer
PY - 2026
DA - 2026/10/21
JO - BMC medical imaging
DO - 10.1186/s12880-026-02940-w
UR - https://europepmc.org/article/MED/42907742
AB - Background PSMA PET/CT plays an important role in biochemically recurrent prostate cancer (BCR-PCa). In general, PET/CT is performed as a limited or true whole-body examination. The majority of PET/CT scanners operate by measuring several bed positions or continuous motion with a limited axial field of view (FOV). Shortening the scan area thus results in a time saving, with unknown information loss regarding the detection of tumor manifestations.Methodology This retrospective single-center study included 200 patients with BCR-PCa after initial curative therapy who underwent a ⁶⁸Ga-PSMA-PET/CT scan from vertex to toe (true whole-body). Using retrospective subdivision into hypothetical partial body measurement protocols, the undetected tumor manifestations were examined. Classic PET/CT protocols were used: vertex to mid-thigh, skull base to mid-thigh, as well as CT-equivalent examination areas: chest/abdomen/pelvis (CAP), abdomen/pelvis (AP) and pelvis.Results Of 200 patients with a median PSA of 1.1 ng/mL, 128 (64%) showed at least one structural correlate of BCR-PCa in the true whole-body scan. The overall detection rate did not change for limited classic PET-protocols, or CAP measurements. CAP scans would not have detected all tumor manifestations in 16 patients (8%) and not all tumor-affected organ systems in six patients (3%), AP scans in 41 patients (21%) and 18 patients (9%), pelvic scans in 61 patients (31%) and 37 patients (19%), respectively. PSA may contribute to the prospective restriction of the scan area. Patients with PSA ≤ 0.75 ng/mL showed no diagnostic gain from whole-body imaging. This means that in 45% of patients in our cohort, a limitation to CAP scan would have been possible without losing information.Conclusions For a resource-saving use of routine PSMA-PET/CT, a scan from the vertex to the mid-thigh seems sufficient for detecting relevant metastases. For patients with low PSA levels, a more focused protocol that includes only the CAP region can be considered.
SN - 1471-2342
ER -