Diagnostic Value of⁶⁸Ga-PSMA PET/CT for Detection of Phosphatase and Tensin Homolog Expression in Prostate Cancer: A Pilot Study

Abstract

Our purpose was to explore the value of 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT for detection of phosphatase and tensin homolog (PTEN)-loss prostate cancer. Methods: We retrospectively enrolled 75 patients who underwent multiparametric MRI and 68 Ga-PSMA PET/CT before radical prostatectomy. Lesions were outlined on pathologic images, and regions of interest were drawn on matched multiparametric MRI and PET/CT images. Imaging parameters, including average apparent diffusion coefficient and SUV max , were derived. Immunohistochemical staining was performed to evaluate the PTEN status. The diagnostic performance of imaging parameters was analyzed by receiver-operating-characteristic analysis. Univariate logistic regression analyses were used to evaluate the association between clinical and imaging variables and PTEN status. Results: In total, 103 lesions from 75 patients were analyzed. Of these lesions, 38 of 103 (36.9%) showed PTEN-loss status. Our study showed a strong association between SUV max and PTEN-loss tumors both in the per-patient analysis (P , 0.01) and in the per-lesion analysis (P , 0.01), yielding sensitivity and specificity of 0.80 and 0.77, respectively, in the perpatient analysis and 0.83 and 0.74, respectively, in the per-lesion analysis. Meanwhile, higher pathologic PSMA expression was found in the PTEN-deficiency tumors. However, there was no significant difference between PTEN-loss tumors and PTEN-intact tumors using parameters such as average apparent diffusion coefficient (P. 0.05) and score on the Prostate Imaging Reporting and Data System, version 2 (P. 0.05). Surprisingly, SUV max was a significant predictor for detection of PTENloss tumors (odds ratio of 7.56 and 95% confidence interval of 2.18-26.24 on per-patient analysis; odds ratio of 13.66 and 95% confidence interval of 4.32-43.24 on per-lesion analysis). Conclusion: 68 Ga-PSMA PET/CT could effectively detect aggressive PTEN-loss tumors.

68Ga-PSMA–Guided Bone Biopsies for Molecular Diagnostics in Patients with Metastatic Prostate Cancer

“…High PSMA expression is associated with defective DNA damage repair and PTEN loss, whereas patients with low 68 Ga-PSMA expression have poor survival (29)(30)(31). Since bone biopsies in this study were not obtained from metastases with low 68 Ga-PSMA uptake, these sites are underrepresented in the current study.…”

68Ga-DOTA-DiPSMA PET/CT Imaging: Biodistribution, Dosimetry, and Preliminary Application in Prostate Cancer

“…Recently, a relatively new nuclear imaging modality 68 Ga-PSMA PET/CT imaging with good PCa diagnosis and staging performance has become increasingly utilized to evaluate PCa aggressiveness, especially in patients with biochemical recurrence after surgery (Sachpekidis et al, 2016;Koerber et al, 2017;Wang et al, 2020). PSMA can be coupled with different chelators and labeled with corresponding radionuclides for different purposes.…”

68Ga-PSMA PET/CT targeted biopsy for the diagnosis of clinically significant prostate cancer compared with transrectal ultrasound guided biopsy: a prospective randomized single-centre study

“…However, a limited number of studies have focused on the primary prostatic lesion [14,15]. We previously showed that 68 Ga-PSMA PET/CT had higher sensitivity for the detection of lymphadenopathy and visceral metastasis compared with mpMRI, and described the clinical characteristics of intra-prostatic primary lesions including tumour size, shape, and location [16][17][18][19].…”