ORIGINAL ARTICLE   

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 March;66(1):67-73

DOI: 10.23736/S1824-4785.19.03172-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

PSMA uptake on [68Ga]-PSMA-11-PET/CT positively correlates with prostate cancer aggressiveness

Mengxia CHEN ¹, Xuefeng QIU ¹, Qing ZHANG ¹, Chengwei ZHANG ¹, Yi-Hua ZHOU ², Xiaozhi ZHAO ¹, Yao FU ³, Feng WANG ⁴, Hongqian GUO ¹ ✉

¹ Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, University of Nanjing, Jiangsu, China; ² Department of Experimental Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, University Medical School of Nanjing, Jiangsu, China; ³ Department of Pathology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China; ⁴ Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

BACKGROUND: Conflicting results have been revealed on the relationship between PSMA uptake values (SUVs) on prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) and prostate cancer (PCa) aggressiveness. This study is to validate the relationship between SUVs with PCa aggressiveness and its role in evaluation of clinically significant PCa (csPCa) and risk stratification.
METHODS: We retrospectively enrolled 51 patients who underwent [68Ga]-PSMA PET/CT (PET/CT) before radical prostatectomy (RP). PET/CT results were corrected with whole mount histology. The relationship between SUVs and aggressiveness related indictors including Gleason score, T stage, initial PSA and tumor size were analyzed. The cutoff value for detection of overall PCa, csPCa and intermediate/high-risk PCa were calculated by receiver operating characteristics (ROC) analysis.
RESULTS: Both SUVmax and SUVmean positively correlated with Gleason score (SUVmax Spearman r=0.546 P<0.01, SUVmean Spearman r=0.359 P<0.01), PSA level (SUVmax Spearman r=0.568 P<0.01, SUVmean Spearman r=0.529 P<0.01) and tumor volume SUVmax Spearman r=0.635 P<0.01, SUVmean Spearman r=0.590 P<0.01). Tumors with T3 stage had significant higher SUV uptake than T2 (SUVmax 17.49±10.50 vs 9.90±8.7, P<0.01 and SUVmean 17.49±10.50 vs 9.90±8.7, P<0.01). ROC analysis showed cutoff of SUVmax (3.8) and SUVmean (2.8) for overall PCa detection. ROC analysis showed that csPCa and intermediate/high risk PCa had the same cutoff on both SUVmax (8.4) and SUVmean (6.8).
CONCLUSIONS: PSMA uptake on PSMA PET/CT positively correlated with Gleason score, T stage, initial PSA and tumor volume. Both SUVmax and SUVmean can be applied as parameters for csPCa detection and risk classification.

KEY WORDS: Prostatic neoplasms; Prostatectomy; Risk; Classification