How does 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery?

Objective To evaluate the clinical impact of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography on the planned management of prostate cancer patients with biochemical recurrence after surgery. Methods We enrolled 276 prostate cancer patients referred to 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography due to biochemical recurrence after surgery (two consecutive prostate‐specific antigen assays ≥0.2 ng/mL). First, the detection rate of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography was assessed according to different prostate‐specific antigen levels. Second, the independent predictors of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography positive results were assessed. Finally, the intended treatment before revision of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography was assessed by a multidisciplinary team based on the European Association of Urology guidelines, patient clinical condition and clinical parameters. Then, re‐assessment of the treatment plan was prospectively recorded by the same board after revision of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography. The effective clinical impact of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography was rated as major (change in therapeutic approach), minor (same treatment, but modified therapeutic strategy) or none. Results The overall detection rate of 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography was 47.5%. Prostate‐specific antigen at 68Ga‐prostate‐specific membrane antigen positron emission tomography/computed tomography (odds ratio 3.52) and prostate‐specific antigen doubling time