18F-PSMA-1007 PET/CT-derived semi-quantitative parameters for risk stratification of newly diagnosed prostate cancer

Abstract

PurposeThis study aimed to assess the value of 18F-PSMA-1007 positron emission tomography/computed tomography (PET/CT)-derived semi-quantitative parameters of primary tumor for risk stratification of newly diagnosed prostate cancer (PCa).MethodsSixty patients referred for 18F-PSMA-1007 PET/CT imaging for primary PCa were retrospectively analyzed and classified into the low-intermediate-risk (LIR) or high-risk (HR) group. The maximum standardized uptake value (SUVmax) of primary tumor, prostate total lesion PSMA (TL-PSMAp), and prostate PSMA-tumor volume (PSMA-TVp) were measured, and group differences were evaluated using the Mann–Whitney U test. Spearman’s correlation was performed to assess the correlation between the above parameters with prostate-specific antigen (PSA) levels and Gleason score (GS). Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for SUVmax, TL-PSMAp, and PSMA-TVp to identify high-risk PCa and compare diagnostic efficacy.ResultsAmong 60 patients, 46 were assigned to the HR group and 16 to the LIR group. In all patients, SUVmax, TL-PSMAp, and PSMA-TVp were moderately correlated with pre-treatment PSA values (r = 0.411, p = 0.001; r = 0.663, p < 0.001; and r = 0.549, p < 0.001, respectively). SUVmax and TL-PSMAp were moderately correlated with GS (r = 0.457 and r = 0.448, respectively; p < 0.001), while PSMA-TVp was weakly correlated with GS (r = 0.285, p = 0.027). In the ROC curve analysis, the optimal cut-off values of SUVmax, TL-PSMAp, and PSMA-TVp for identifying high-risk PCa were 9.61, 59.62, and 10.27, respectively, and the areas under the operating curve were 0.828, 0.901, and 0.809, respectively. The sensitivities of SUVmax, TL-PSMAp, and PSMA-TVp were 91.03%, 71.74%, and 63.04%, respectively, and the specificities were 71.43%, 100.00%, and 92.86%, respectively.ConclusionsTL-PSMAp had a superior ability to identify high-risk PCa. The semi-quantitative parameters of primary tumor on 18F-PSMA-1007 PET/CT imaging can be an objective imaging reference index to determine PCa risk stratification.

Prostate zones and tumor morphological parameters on magnetic resonance imaging for predicting the tumor-stage diagnosis of prostate cancer

“… 29 , 30 However, Mayer et al 31 reported that histology-based TV is related to the GS (r = 0.498, P = 0.0098), and Baba et al 9 suggested that the optimal TV cut-off value for predicting BCR was 2.8 cc (AUC: 0.690). Moreover, Castiglione et al 32 concluded that for high-risk patients with PCa, a TV >6.29 cc (AUC: 0.722) leads to CF, and Dong et al 33 reported that the optimal cut-off value for identifying the best maximum standardized uptake value (SUV max ) for high-risk patients with PCa was 9.61 (AUC: 0.828). Furthermore, Jiao et al 34 established and prospectively verified that the optimal SUV max cut-off value for discriminating clinically significant PCa from BPH was 5.30, with AUCs of 0.893 in the training and 0.853 in the prospective validation cohorts.…”

Predictive value of volumetric parameters based on 18F-PSMA-1007 PET/CT for prostate cancer metastasis

“…Increasing evidence suggests that tumor invasiveness is related to tumor volume and burden, the tumor volume is considered as an independent risk factor in biochemical recurrence of PCa ( 23 ). Therefore, volume parameters such as prostate PSMA-tumor volume (PSMA-TVp) and prostate total lesion PSMA (TL-PSMAp) are also being studied to overcome the above-mentioned limitations ( 24 , 25 ). However, there are few studies on the clinical application of tumor volume with PSMA PET/CT.…”