Evaluation of RECIST, PERCIST, EORTC, and MDA Criteria for Assessing Treatment Response with Ga68-PSMA PET-CT in Metastatic Prostate Cancer Patient with Biochemical Progression: a Comparative Study

Abstract

The aim of the study was to compare response evaluation criteria in solid tumours 1.1 (RECIST 1.1), positron emission tomography response criteria in solid tumours (PERCIST), European organisation for research and treatment of cancer (EORTC), and MD Anderson (MDA) criteria for response assessment by Gallium 68-prostate-specific membrane antigen positron emission tomography-computed tomography (Ga68-PSMA PET-CT) in metastatic adenocarcinoma prostate cancer (mPCa) patients with biochemical progression. Methods Eighty-eight mPCa patients with pre and post treatment Ga68-PSMA PET-CT were included. A ≥ 25% increase and ≥ 2 ng/ml above the nadir if prostate specific antigen (PSA) drop or ≥ 2 ng/ml above the baseline if PSA does not drop was considered as biochemical progression. RECIST 1.1 and MDA criteria for morphology and PERCIST and EORTC criteria for molecular response were investigated. Percentages of progressive disease (PD), partial response (PR), and stable disease (SD) were calculated. Chi-square test was used for statistical significance.

Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

“…Paying tribute to the growing importance of PSMA PET/CT imaging, PET/CT-derived criteria were transferred accordingly to PCa patient subgroups. For 68 Ga-PSMA PET/CT scans, adapted PERCIST criteria performed better than morphological criteria such as RECIST in metastatic PCa [21], 177 Lu-PSMA-therapy [22] or patients undergoing docetaxel therapy [17]. Schmuck et al were the first to analyse the overlap of PSMA-TV, TL-PSMA and BR for PCa patients [10].…”

Proposal for Systemic-Therapy Response-Assessment Criteria at the Time of PSMA PET/CT Imaging: The PSMA PET Progression Criteria

“…Similary, PERCIST (6) and EORTC (11) for FDG PET imaging are robust response criteria using defined changes in lesion SUV. However, as semi-quantitative values are not established for PSMA PET these response approaches cannot be directly translated into PSMA PET imaging (12). PPP aims to reliably identify disease progression while avoiding false positives.…”

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

“…However, not many papers are published about response monitoring or active surveillance using [ 68 Ga]Ga-PSMA-11 PET/CT [ 12 ]. One study by Gupta et al [ 13 ] compared the functional criteria PERCIST 1.0 and EORTC in [ 68 Ga]Ga-PSMA-11 PET/CT with the morphological criteria according to RECIST V1.1 in patients with metastatic PCa and biochemical progression. According to this study, molecular imaging criteria performed best in detecting progression based on changes of ≥ 25% SUV mean (EORTC) or ≥ 30% SUL peak (PERCIST) after hormone treatment [ 13 ].…”

“…One study by Gupta et al [ 13 ] compared the functional criteria PERCIST 1.0 and EORTC in [ 68 Ga]Ga-PSMA-11 PET/CT with the morphological criteria according to RECIST V1.1 in patients with metastatic PCa and biochemical progression. According to this study, molecular imaging criteria performed best in detecting progression based on changes of ≥ 25% SUV mean (EORTC) or ≥ 30% SUL peak (PERCIST) after hormone treatment [ 13 ]. However, the study does not describe if the biological variation in [ 68 Ga]Ga-PSMA-11 uptake is comparable to that of [ 18 F]FDG, and if the same cutoff values apply, while only changes that exceed the normal variability should be interpreted as treatment response or disease progression .…”