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Quantitative PSMA-PET parameters in localized prostate cancer: prognostic and potential predictive value

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Title: Quantitative PSMA-PET parameters in localized prostate cancer: prognostic and potential predictive value
Authors: Stephanie Bela Andela, Holger Amthauer, Christian Furth, Julian M. Rogasch, Marcus Beck, Felix Mehrhof, Pirus Ghadjar, Jörg van den Hoff, Tobias Klatte, Rana Tahbaz, Daniel Zips, Frank Hofheinz, Sebastian Zschaeck
Source: Radiat Oncol
Radiation Oncology, Vol 19, Iss 1, Pp 1-11 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Antigens, Surface/analysis [MeSH], Positron emission tomography, Glutamate Carboxypeptidase II/metabolism [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Humans [MeSH], Prognostic value, Prostatic Neoplasms/metabolism [MeSH], Radiopharmaceuticals [MeSH], Prostate-specific membrane antigen, Prostatic Neoplasms/pathology [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Antigens, Surface/metabolism [MeSH], Prostatic Neoplasms/diagnostic imaging [MeSH], PSMA, Prostatic Neoplasms/radiotherapy [MeSH], Positron-Emission Tomography/methods [MeSH], Male [MeSH], Research, Prognosis [MeSH], Quantitative PET parameters, Prostate cancer, Male, Glutamate Carboxypeptidase II, R895-920, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, Humans, RC254-282, Retrospective Studies, Aged, Aged, 80 and over, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prostatic Neoplasms, Middle Aged, Prognosis, 3. Good health, Positron-Emission Tomography, Antigens, Surface, Radiopharmaceuticals
Description: Background PSMA-PET is increasingly used for staging prostate cancer (PCA) patients. However, it is not clear if quantitative imaging parameters of positron emission tomography (PET) have an impact on disease progression and are thus important for the prognosis of localized PCA. Methods This is a monocenter retrospective analysis of 86 consecutive patients with localized intermediate or high-risk PCA and PSMA-PET before treatment The quantitative PET parameters maximum standardized uptake value (SUVmax), tumor asphericity (ASP), PSMA tumor volume (PSMA-TV), and PSMA total lesion uptake (PSMA-TLU = PSMA-TV × SUVmean) were assessed for their prognostic significance in patients with radiotherapy or surgery. Cox regression analyses were performed for biochemical recurrence-free survival, overall survival (OS), local control, and loco-regional control (LRC). Results 67% of patients had high-risk disease, 51 patients were treated with radiotherapy, and 35 with surgery. Analysis of metric PET parameters in the whole cohort revealed a significant association of PSMA-TV (p = 0.003), PSMA-TLU (p = 0.004), and ASP (p max (8.6) showed a significant association with LRC in surgically treated (p = 0.048), but not in primary irradiated (p = 0.34) patients. In addition, PSMA-TLU (p = 0.016) seemed to be a very promising biomarker to stratify surgical patients. Conclusion Our data confirm one previous publication on the prognostic impact of SUVmax in surgically treated patients with high-risk PCA. Our exploratory analysis indicates that PSMA-TLU might be even better suited. The missing association with primary irradiated patients needs prospective validation with a larger sample size to conclude a predictive potential. Trial registration Due to the retrospective nature of this research, no registration was carried out.
Document Type: Article
Other literature type
Language: English
ISSN: 1748-717X
DOI: 10.1186/s13014-024-02483-w
Access URL: https://pubmed.ncbi.nlm.nih.gov/39080696
https://doaj.org/article/2cd9702345744663b11a692d8b95dabe
https://repository.publisso.de/resource/frl:6519673
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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– Name: Abstract
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  Data: Background PSMA-PET is increasingly used for staging prostate cancer (PCA) patients. However, it is not clear if quantitative imaging parameters of positron emission tomography (PET) have an impact on disease progression and are thus important for the prognosis of localized PCA. Methods This is a monocenter retrospective analysis of 86 consecutive patients with localized intermediate or high-risk PCA and PSMA-PET before treatment The quantitative PET parameters maximum standardized uptake value (SUVmax), tumor asphericity (ASP), PSMA tumor volume (PSMA-TV), and PSMA total lesion uptake (PSMA-TLU = PSMA-TV × SUVmean) were assessed for their prognostic significance in patients with radiotherapy or surgery. Cox regression analyses were performed for biochemical recurrence-free survival, overall survival (OS), local control, and loco-regional control (LRC). Results 67% of patients had high-risk disease, 51 patients were treated with radiotherapy, and 35 with surgery. Analysis of metric PET parameters in the whole cohort revealed a significant association of PSMA-TV (p = 0.003), PSMA-TLU (p = 0.004), and ASP (p max (8.6) showed a significant association with LRC in surgically treated (p = 0.048), but not in primary irradiated (p = 0.34) patients. In addition, PSMA-TLU (p = 0.016) seemed to be a very promising biomarker to stratify surgical patients. Conclusion Our data confirm one previous publication on the prognostic impact of SUVmax in surgically treated patients with high-risk PCA. Our exploratory analysis indicates that PSMA-TLU might be even better suited. The missing association with primary irradiated patients needs prospective validation with a larger sample size to conclude a predictive potential. Trial registration Due to the retrospective nature of this research, no registration was carried out.
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  Data: CC BY<br />URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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        Value: 10.1186/s13014-024-02483-w
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    Subjects:
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        Type: general
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