Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma
Men diagnosed with aggressive prostate cancer are at high risk of local relapse or systemic progression after definitive treatment. Treatment intensification is highly needed for that patient cohort; however, no relevant stratification tool has been implemented into the clinical work routine so far....
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/13/7/1508 |
| _version_ | 1797540117248737280 |
|---|---|
| author | Stefan A. Koerber Johannes Boesch Clemens Kratochwil Ingmar Schlampp Jonas Ristau Erik Winter Stefanie Zschaebitz Luisa Hofer Klaus Herfarth Klaus Kopka Tim Holland-Letz Dirk Jaeger Markus Hohenfellner Uwe Haberkorn Juergen Debus Frederik L. Giesel |
| author_facet | Stefan A. Koerber Johannes Boesch Clemens Kratochwil Ingmar Schlampp Jonas Ristau Erik Winter Stefanie Zschaebitz Luisa Hofer Klaus Herfarth Klaus Kopka Tim Holland-Letz Dirk Jaeger Markus Hohenfellner Uwe Haberkorn Juergen Debus Frederik L. Giesel |
| author_sort | Stefan A. Koerber |
| collection | DOAJ |
| description | Men diagnosed with aggressive prostate cancer are at high risk of local relapse or systemic progression after definitive treatment. Treatment intensification is highly needed for that patient cohort; however, no relevant stratification tool has been implemented into the clinical work routine so far. Therefore, the aim of the current study was to analyze the role of initial PSMA-PET/CT as a prediction tool for metastases. In total, 335 men with biopsy-proven prostate carcinoma and PSMA-PET/CT for primary staging were enrolled in the present, retrospective study. The number and site of metastases were analyzed and correlated with the maximum standardized uptake value (SUVmax) of the intraprostatic, malignant lesion. Receiver operating characteristic (ROC) curves were used to determine sensitivity and specificity and a model was created using multiple logistic regression. PSMA-PET/CT detected 171 metastases with PSMA-uptake in 82 patients. A statistically significant higher SUVmax was found for men with metastatic disease than for the cohort without distant metastases (median 16.1 vs. 11.2; <i>p</i> < 0.001). The area under the curve (AUC) in regard to predicting the presence of any metastases was 0.65. Choosing a cut-off value of 11.9 for SUVmax, a sensitivity and specificity (factor 1:1) of 76.0% and 58.4% was obtained. The current study confirms, that initial PSMA-PET/CT is able to detect a relatively high number of treatment-naïve men with metastatic prostate carcinoma. Intraprostatic SUVmax seems to be a promising parameter for the prediction of distant disease and could be used for treatment stratification—aspects which should be verified within prospective trials. |
| first_indexed | 2024-03-10T12:55:32Z |
| format | Article |
| id | doaj.art-cf2ef43403754d0b95886d87fa04eab2 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:55:32Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cf2ef43403754d0b95886d87fa04eab22023-11-21T11:58:19ZengMDPI AGCancers2072-66942021-03-01137150810.3390/cancers13071508Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate CarcinomaStefan A. Koerber0Johannes Boesch1Clemens Kratochwil2Ingmar Schlampp3Jonas Ristau4Erik Winter5Stefanie Zschaebitz6Luisa Hofer7Klaus Herfarth8Klaus Kopka9Tim Holland-Letz10Dirk Jaeger11Markus Hohenfellner12Uwe Haberkorn13Juergen Debus14Frederik L. Giesel15Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Urology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, 01328 Dresden, GermanyDepartment of Biostatistics, German Cancer Research Center (DKFZ), 69120 Heidelberg, GermanyDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Urology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyMen diagnosed with aggressive prostate cancer are at high risk of local relapse or systemic progression after definitive treatment. Treatment intensification is highly needed for that patient cohort; however, no relevant stratification tool has been implemented into the clinical work routine so far. Therefore, the aim of the current study was to analyze the role of initial PSMA-PET/CT as a prediction tool for metastases. In total, 335 men with biopsy-proven prostate carcinoma and PSMA-PET/CT for primary staging were enrolled in the present, retrospective study. The number and site of metastases were analyzed and correlated with the maximum standardized uptake value (SUVmax) of the intraprostatic, malignant lesion. Receiver operating characteristic (ROC) curves were used to determine sensitivity and specificity and a model was created using multiple logistic regression. PSMA-PET/CT detected 171 metastases with PSMA-uptake in 82 patients. A statistically significant higher SUVmax was found for men with metastatic disease than for the cohort without distant metastases (median 16.1 vs. 11.2; <i>p</i> < 0.001). The area under the curve (AUC) in regard to predicting the presence of any metastases was 0.65. Choosing a cut-off value of 11.9 for SUVmax, a sensitivity and specificity (factor 1:1) of 76.0% and 58.4% was obtained. The current study confirms, that initial PSMA-PET/CT is able to detect a relatively high number of treatment-naïve men with metastatic prostate carcinoma. Intraprostatic SUVmax seems to be a promising parameter for the prediction of distant disease and could be used for treatment stratification—aspects which should be verified within prospective trials.https://www.mdpi.com/2072-6694/13/7/1508prostate cancerPSMAPETmetastasesintraprostatic SUV |
| spellingShingle | Stefan A. Koerber Johannes Boesch Clemens Kratochwil Ingmar Schlampp Jonas Ristau Erik Winter Stefanie Zschaebitz Luisa Hofer Klaus Herfarth Klaus Kopka Tim Holland-Letz Dirk Jaeger Markus Hohenfellner Uwe Haberkorn Juergen Debus Frederik L. Giesel Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma Cancers prostate cancer PSMA PET metastases intraprostatic SUV |
| title | Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma |
| title_full | Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma |
| title_fullStr | Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma |
| title_full_unstemmed | Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma |
| title_short | Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma |
| title_sort | predicting the risk of metastases by psma pet ct evaluation of 335 men with treatment naive prostate carcinoma |
| topic | prostate cancer PSMA PET metastases intraprostatic SUV |
| url | https://www.mdpi.com/2072-6694/13/7/1508 |
| work_keys_str_mv | AT stefanakoerber predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT johannesboesch predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT clemenskratochwil predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT ingmarschlampp predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT jonasristau predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT erikwinter predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT stefaniezschaebitz predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT luisahofer predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT klausherfarth predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT klauskopka predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT timhollandletz predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT dirkjaeger predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT markushohenfellner predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT uwehaberkorn predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT juergendebus predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma AT frederiklgiesel predictingtheriskofmetastasesbypsmapetctevaluationof335menwithtreatmentnaiveprostatecarcinoma |