Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer
Background: We aimed to evaluate the utility of prostate-specific membrane antigen (PSMA) PET/CT for the detection of local disease within the prostate. Methods: This is a retrospective review of a single-center experience evaluating intraprostatic detection rates compared with final histopathology...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888220300544 |
| _version_ | 1797714965725970432 |
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| author | Timothy N. Kwan Sandra Spremo Amy Y.M. Teh David McHarg Isaac Thangasamy Henry H. Woo |
| author_facet | Timothy N. Kwan Sandra Spremo Amy Y.M. Teh David McHarg Isaac Thangasamy Henry H. Woo |
| author_sort | Timothy N. Kwan |
| collection | DOAJ |
| description | Background: We aimed to evaluate the utility of prostate-specific membrane antigen (PSMA) PET/CT for the detection of local disease within the prostate. Methods: This is a retrospective review of a single-center experience evaluating intraprostatic detection rates compared with final histopathology in a radical prostatectomy (RP) population. Seventy-two patients had PSMA PET/CT scan performed as part of their primary staging. Intraprostatic PSMA PET/CT avidity was assessed. PSMA PET/CT uptake was retrospectively correlated with patient characteristics including final histopathology, MRI Prostate Imaging Reporting and Data System (PI-RADS) score, clinical tumor stage, prostate-specific antigen (PSA) level, and patient age. Results: The sensitivity of PSMA PET/CT for the detection of RP-confirmed prostate cancer was 81.2%. Much higher sensitivity was found within certain subpopulations. The patient characteristics that most strongly correlated with focal intraprostatic PSMA PET/CT uptake were patient age (Kendall's tau coefficient τb = 0.24, p < 0.05) and clinical T stage (τb = 0.21, p < 0.05).The International Society of Urological Pathology (ISUP) grade group from final RP was predicted by standardized uptake value (SUVmax) and to a lesser extent PSA and the maximal dimension of PET-avid lesions. SUVmax monotonically increased with ISUP grade group. If SUVmax was above 10 g/mL, the final RP histopathology had a relative risk of 2.3 (95% CI 1.3–4.1) of being ISUP grade group 5. Conclusion: This trial provides early evidence that PSMA PET/CT assists in the grading of prostate cancer and suggests that the imaging modality is particularly accurate in subpopulations including the elderly and those with palpable disease. |
| first_indexed | 2024-03-12T07:59:48Z |
| format | Article |
| id | doaj.art-59ed53b02261496e9f02858b397a032f |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T07:59:48Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-59ed53b02261496e9f02858b397a032f2023-09-02T19:55:17ZengElsevierProstate International2287-88822021-06-0192107112Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancerTimothy N. Kwan0Sandra Spremo1Amy Y.M. Teh2David McHarg3Isaac Thangasamy4Henry H. Woo5University of Sydney, AustraliaUniversity of Sydney, AustraliaUniversity of Sydney, AustraliaNorthern Nuclear Medicine, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Queensland, AustraliaUniversity of Sydney, Australia; Corresponding author. San Clinic, Suite 406, 185 Fox Valley Road, Wahroonga, Australia.Background: We aimed to evaluate the utility of prostate-specific membrane antigen (PSMA) PET/CT for the detection of local disease within the prostate. Methods: This is a retrospective review of a single-center experience evaluating intraprostatic detection rates compared with final histopathology in a radical prostatectomy (RP) population. Seventy-two patients had PSMA PET/CT scan performed as part of their primary staging. Intraprostatic PSMA PET/CT avidity was assessed. PSMA PET/CT uptake was retrospectively correlated with patient characteristics including final histopathology, MRI Prostate Imaging Reporting and Data System (PI-RADS) score, clinical tumor stage, prostate-specific antigen (PSA) level, and patient age. Results: The sensitivity of PSMA PET/CT for the detection of RP-confirmed prostate cancer was 81.2%. Much higher sensitivity was found within certain subpopulations. The patient characteristics that most strongly correlated with focal intraprostatic PSMA PET/CT uptake were patient age (Kendall's tau coefficient τb = 0.24, p < 0.05) and clinical T stage (τb = 0.21, p < 0.05).The International Society of Urological Pathology (ISUP) grade group from final RP was predicted by standardized uptake value (SUVmax) and to a lesser extent PSA and the maximal dimension of PET-avid lesions. SUVmax monotonically increased with ISUP grade group. If SUVmax was above 10 g/mL, the final RP histopathology had a relative risk of 2.3 (95% CI 1.3–4.1) of being ISUP grade group 5. Conclusion: This trial provides early evidence that PSMA PET/CT assists in the grading of prostate cancer and suggests that the imaging modality is particularly accurate in subpopulations including the elderly and those with palpable disease.http://www.sciencedirect.com/science/article/pii/S2287888220300544Prostatic neoplasmsPositron-emission tomographyObservational study |
| spellingShingle | Timothy N. Kwan Sandra Spremo Amy Y.M. Teh David McHarg Isaac Thangasamy Henry H. Woo Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer Prostate International Prostatic neoplasms Positron-emission tomography Observational study |
| title | Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer |
| title_full | Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer |
| title_fullStr | Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer |
| title_full_unstemmed | Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer |
| title_short | Performance of Ga-68 PSMA PET/CT for diagnosis and grading of local prostate cancer |
| title_sort | performance of ga 68 psma pet ct for diagnosis and grading of local prostate cancer |
| topic | Prostatic neoplasms Positron-emission tomography Observational study |
| url | http://www.sciencedirect.com/science/article/pii/S2287888220300544 |
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