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Niu XB, Li YP, Wang J, Mei XL, Zhao XY, Liu TT, Xu SS, Han XM, Cheng JL. Diagnostic value of 18F-PSMA-1007 PET/CT for predicting the pathological grade of prostate cancer. Cancer Biol Ther 2024; 25:2287120. [PMID: 38117551 PMCID: PMC10761109 DOI: 10.1080/15384047.2023.2287120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
This study was designed to evaluate the diagnostic efficacy of relevant parameters of 18F-prostate-specific membrane antigen (PSMA)-1007 PET/CT in predicting the pathological grade of primary prostate cancer. Briefly, a prospective analysis was performed on 53 patients diagnosed with prostate cancer by systematic puncture biopsy, followed by 18F-PSMA-1007 PET/CT examination prior to treatment within 10 d. The patients were grouped in accordance with the Gleason grading system revised by the International Association of Urology Pathology (ISUP). They were divided into high-grade group (ISUP 4-5 group) and low-grade group (ISUP 1-3 group). The differences in maximum standardized uptake value (SUVmax), tumor-to-background ratio (TBR), intraprostatic PSMA-derived tumor volume (iPSMA-TV), and intraprostatic total lesion PSMA (iTL-PSMA) between the high- and low-grade group were statistically significant (p < .001). No significant difference was found for mean standardized uptake value (SUVmean) between the high- and low-grade groups (Z = -1.131, p = .258). Besides, binary multivariate logistic regression analysis showed that only iPSMA-TV and iTL-PSMA were independent predictors of the pathological grading, for which the odds ratios were 18.821 [95% confidence interval (CI): 2.040-173.614, p = .010] and 0.758 (95% CI: 0.613-0.938, p = .011), respectively. The area under the ROC of this regression model was 0.983 (95% CI: 0.958-1.00, p < .001). Only iTL-PSMA was a significant parameter for distinguishing ISUP-4 and ISUP-5 groups (Z = -2.043, p = .041). In a nutshell, 18F-PSMA-1007 PET/CT has good application value in predicting the histopathological grade of primary prostate cancer. Three-dimensional volume metabolism parameters iPSMA-TV and iTL-PSMA were found to be independent predictors for pathological grade.
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Affiliation(s)
- Xiao-Bo Niu
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Yan-Peng Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Jun Wang
- Department of Urinary Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xiao-Li Mei
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xue-Yan Zhao
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Ting-Ting Liu
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Sha-Sha Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xing-Min Han
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Jing-Liang Cheng
- Department of Magnetic resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
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Heetman JG, Paulino Pereira LJ, Kelder JC, Soeterik TFW, Wever L, Lavalaye J, van der Hoeven EJRJ, Lam MGEH, van Melick HHE, van den Bergh RCN. The additional value of 68Ga-PSMA PET/CT SUVmax in predicting ISUP GG ≥ 2 and ISUP GG ≥ 3 prostate cancer in biopsy. Prostate 2024; 84:1025-1032. [PMID: 38704755 DOI: 10.1002/pros.24716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/25/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Prebiopsy magnetic resonance imaging (MRI) increases the detection rate of clinically significant prostate cancer (csPCa). Prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA PET/CT) maximum standardized uptake value (SUVmax) of the prostate may offer additional value in predicting the likelihood of csPCa in biopsy. METHODS A single-center cohort study involving patients with biopsy-proven PCa who underwent both MRI and PSMA PET/CT between 2020 and 2021. Logistic regression models were developed for International Society of Urological Pathology (ISUP) Grade Group (GG) ≥ 2 and GG ≥ 3 using noninvasive prebiopsy parameters: age, (log-)prostate-specific antigen (PSA) density, PI-RADS 5 lesion presence, extraprostatic extension (EPE) on MRI, and SUVmax of the prostate. Models with and without SUVmax were compared using Likelihood ratio tests and area under the curve (AUC). DeLong's test was used to compare the AUCs. RESULTS The study included 386 patients, with 262 (68%) having ISUP GG ≥ 2 and 180 (47%) having ISUP GG ≥ 3. Including SUVmax significantly improved both models' goodness of fit (p < 0.001). The GG ≥ 2 model had a higher AUC with SUVmax 89.16% (95% confidence interval [CI]: 86.06%-92.26%) than without 87.34% (95% CI: 83.93%-90.76%) (p = 0.026). Similarly, the GG ≥ 3 model had a higher AUC with SUVmax 82.51% (95% CI: 78.41%-86.6%) than without 79.33% (95% CI: 74.84%-83.83%) (p = 0.003). The SUVmax inclusion improved the GG ≥ 3 model's calibration at higher probabilities. CONCLUSION SUVmax of the prostate on PSMA PET/CT potentially improves diagnostic accuracy in predicting the likelihood of csPCa in prostate biopsy.
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Affiliation(s)
- Joris G Heetman
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | | | - Johannes C Kelder
- Department of Cardiology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Timo F W Soeterik
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Lieke Wever
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Jules Lavalaye
- Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | | | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Harm H E van Melick
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
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Li T, Xu M, Yang S, Wang G, Liu Y, Liu K, Zhao K, Su X. Development and validation of [18 F]-PSMA-1007 PET-based radiomics model to predict biochemical recurrence-free survival following radical prostatectomy. Eur J Nucl Med Mol Imaging 2024; 51:2806-2818. [PMID: 38691111 DOI: 10.1007/s00259-024-06734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Biochemical recurrence (BCR) following radical prostatectomy (RP) is a significant concern for patients with prostate cancer. Reliable prediction models are needed to identify patients at risk for BCR and facilitate appropriate management. This study aimed to develop and validate a clinical-radiomics model based on preoperative [18 F]PSMA-1007 PET for predicting BCR-free survival (BRFS) in patients who underwent RP for prostate cancer. MATERIALS AND METHODS A total of 236 patients with histologically confirmed prostate cancer who underwent RP were retrospectively analyzed. All patients had a preoperative [18 F]PSMA-1007 PET/CT scan. Radiomics features were extracted from the primary tumor region on PET images. A radiomics signature was developed using the least absolute shrinkage and selection operator (LASSO) Cox regression model. The performance of the radiomics signature in predicting BRFS was assessed using Harrell's concordance index (C-index). The clinical-radiomics nomogram was constructed using the radiomics signature and clinical features. The model was externally validated in an independent cohort of 98 patients. RESULTS The radiomics signature comprised three features and demonstrated a C-index of 0.76 (95% CI: 0.60-0.91) in the training cohort and 0.71 (95% CI: 0.63-0.79) in the validation cohort. The radiomics signature remained an independent predictor of BRFS in multivariable analysis (HR: 2.48, 95% CI: 1.47-4.17, p < 0.001). The clinical-radiomics nomogram significantly improved the prediction performance (C-index: 0.81, 95% CI: 0.66-0.95, p = 0.007) in the training cohort and (C-index: 0.78 95% CI: 0.63-0.89, p < 0.001) in the validation cohort. CONCLUSION We developed and validated a novel [18 F]PSMA-1007 PET-based clinical-radiomics model that can predict BRFS following RP in prostate cancer patients. This model may be useful in identifying patients with a higher risk of BCR, thus enabling personalized risk stratification and tailored management strategies.
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Affiliation(s)
- Tiancheng Li
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Mimi Xu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Shuye Yang
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Guolin Wang
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Yinuo Liu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Kaifeng Liu
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Kui Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Xinhui Su
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China.
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Hou H, Pan Y, Wang Y, Ma Y, Niu X, Sun S, Hou G, Tao W, Gao F. Development and first-in-human study of PSMA-targeted PET tracers with improved pharmacokinetic properties. Eur J Nucl Med Mol Imaging 2024; 51:2819-2832. [PMID: 38683349 DOI: 10.1007/s00259-024-06726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE A series of new 68Ga-labeled tracers based on [68Ga]Ga-PSMA-617 were developed to augment the tumor-to-kidney ratio and reduce the activity accumulation in bladder, ultimately minimize radiation toxicity to the urinary system. METHODS We introduced quinoline group, phenylalanine and decanoic acid into different tracers to enhance their lipophilicity, strategically limiting their metabolic pathway through the urinary system. Their binding affinity onto LNCaP cells was determined through in vitro saturation assays and competition binding assays. In vivo metabolic study, PET imaging and biodistribution experiment were performed in LNCaP tumor-bearing B-NSG male mice. The most promising tracer was selected for first-in-human study. RESULTS Four radiotracers were synthesized with radiochemical purity (RCP) > 95% and molar activity in a range of 20.0-25.5 GBq/μmol. The binding affinities (Ki) of TWS01, TWS02 to PSMA were in the low nanomolar range (< 10 nM), while TWS03 and TWS04 exhibited binding affinities with Ki > 20 nM (59.42 nM for TWS03 and 37.14 nM for TWS04). All radiotracers exhibited high stability in vivo except [68Ga]Ga-TWS03. Micro PET/CT imaging and biodistribution analysis revealed that [68Ga]Ga-TWS02 enabled clear tumor visualization in PET images at 1.5 h post-injection, with higher tumor-to-kidney ratio (T/K, 0.93) and tumor-to-muscle ratio (T/M, 107.62) compared with [68Ga]Ga-PSMA-617 (T/K: 0.39, T/M: 15.01) and [68Ga]Ga-PSMA-11 (T/K: 0.15, T/M: 24.00). In first-in-human study, [68Ga]Ga-TWS02 effectively detected PCa-associated lesions including primary and metastatic lesions, with lower accumulation in urinary system, suggesting that [68Ga]Ga-TWS02 might be applied in the detection of bladder invasion, with minimized radiation toxicity to the urinary system. CONCLUSION Introduction of quinoline group, phenylalanine and decanoic acid into different tracers can modulate the binding affinity and pharmacokinetics of PSMA in vivo. [68Ga]Ga-TWS02 showed high binding affinity to PSMA, excellent pharmacokinetic properties and clear imaging of PCa-associated lesions, making it a promising radiotracer for the clinical diagnosis of PCa. Moreover, TWS02 with a chelator DOTA could also label 177Lu and 225Ac, which could be used for PCa treatment without significant side effects. TRIAL REGISTRATION The clinical evaluation of this study was registered On October 30, 2021 at https://www.chictr.org.cn/ (No: ChiCTR2100052545).
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Affiliation(s)
- Haodong Hou
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yuan Pan
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yanzhi Wang
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yuze Ma
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Xiaobing Niu
- Department of Urology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223300, Jiangsu, China
| | - Suan Sun
- Department of Pathology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223300, Jiangsu, China
| | - Guihua Hou
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.
| | - Weijing Tao
- Department of Nuclear Medicine, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223300, Jiangsu, China.
| | - Feng Gao
- Key Laboratory for Experimental Teratology of the Ministry of Education and Research Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.
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Chandekar KR, Satapathy S, Singh H, Kumar R, Kumar S, Kakkar N, Mittal BR, Singh SK. Utility of PSMA-PET derived volumetric parameters in initial risk stratification and prediction of prostate cancer metastasis - a head-to-head comparison of the radiotracers 18F-PSMA-1007 and 68Ga-PSMA-11. Nucl Med Commun 2024:00006231-990000000-00314. [PMID: 38932503 DOI: 10.1097/mnm.0000000000001874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVE This study aimed to explore and compare the utility of baseline 18F-PSMA-1007 and 68Ga-PSMA-11 PET/computed tomography (CT) derived volumetric parameters in initial risk stratification and prediction of prostate cancer (PCa) metastasis. METHODS Forty treatment-naïve, biopsy-proven intermediate-/high-risk PCa patients were prospectively recruited. Each patient underwent PET/CT with 68Ga-PSMA-11 and 18F-PSMA-1007 (within 2 weeks). The maximum and mean standardized uptake values (SUVmax and SUVmean) of primary tumor, prostate PSMA-tumor volume (PSMA-TVp), and prostate total lesion PSMA (TL-PSMAp) were measured. RESULTS PSMA-TVp and TL-PSMAp (with both radiotracers) mostly exhibited moderate-to-strong correlation with Gleason score, serum prostate-specific antigen level and clinical tumor stage (Spearman ρ = 0.361-0.783, P-values ≤0.022). Primary tumor SUVmax values were similar across initial risk categories. PSMA-TVp and TL-PSMAp, however, were significantly higher in high-risk PCa compared to intermediate-risk PCa (P-values ≤0.001). Receiver operating characteristic (ROC) curve analysis revealed that F-PSMA-TVp, Ga-PSMA-TVp, F-TL-PSMAp, and Ga-TL-PSMAp (optimal cutoff values of 20.9, 23.4, 142.5, and 144.8, respectively) could effectively differentiate high-risk from intermediate-risk PCa [area under the ROC curve (AUCs) 0.859-0.898, P-values <0.001] with high sensitivity (~68.8-75%) and excellent specificity (100%). PSMA-TVp and TL-PSMAp (with both radiotracers) could predict presence of regional and extraregional nodal metastasis (AUCs 0.703-0.801, P-values ≤0.03) with moderate sensitivity (~47.8-70.6%) and excellent specificity (~82.6-94.1%). CONCLUSION Our results suggest that baseline PSMA-PET primary tumor volumetric parameters provide a noninvasive, objective, and accurate index for initial risk stratification and can predict presence of regional and extraregional nodal metastasis in PCa patients. Larger studies are warranted to evaluate their incremental role over conventional parameters.
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Affiliation(s)
- Kunal Ramesh Chandekar
- Department of Nuclear Medicine
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi
| | - Swayamjeet Satapathy
- Department of Nuclear Medicine
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi
| | | | | | | | - Nandita Kakkar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh
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Dullea A, O'Sullivan L, O'Brien KK, Carrigan M, Ahern S, McGarry M, Harrington P, Walsh KA, Smith SM, Ryan M. Diagnostic Accuracy of 18F-Prostate Specific Membrane Antigen (PSMA) PET/CT Radiotracers in Staging and Restaging of Patients With High-Risk Prostate Cancer or Biochemical Recurrence: An Overview of Reviews. Semin Nucl Med 2024:S0001-2998(24)00044-8. [PMID: 38906759 DOI: 10.1053/j.semnuclmed.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/03/2024] [Indexed: 06/23/2024]
Abstract
The aim of this overview was to consolidate existing evidence syntheses and provide a comprehensive overview of the evidence for 18F-prostate specific membrane antigen (PSMA) PET/CT in the staging of high-risk prostate cancer and restaging after biochemical recurrence. An overview of reviews was performed and reported in line with the preferred reporting items for overview of reviews (PRIOR) statement and synthesis without meta-analysis (SWiM) reporting guidelines. A comprehensive database and grey literature search were conducted up to July 18, 2023. Systematic reviews were assessed using the risk of bias in systematic reviews (ROBIS) tool. The certainty of the evidence was assessed using grading of recommendations, assessment, development and evaluations (GRADE). 11 systematic reviews were identified; 10 were at high or unclear risk of bias. Evidence reported on a per-patient, per-lymph node, and per-lesion basis for sensitivity, specificity and overall accuracy was identified. There was a lack of data on dose, adverse events and evidence directly comparing 18F-PSMA PET/CT to other imaging modalities. Evidence with moderate to very low certainty indicated high sensitivity, specificity and accuracy of 18F-PSMA PET/CT in patients with high-risk prostate cancer and biochemical recurrence. There was considerably lower certainty evidence and greater variability in effect estimates for outcomes for the combined intermediate/high-risk cohort. While evidence gaps remain for some outcomes, and most systematic reviews were at high or unclear risk of bias, the current evidence base is broadly supportive of 18F-PSMA PET/CT imaging in the staging and restaging of patients with high-risk prostate cancer and biochemical recurrence.
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Affiliation(s)
- Andrew Dullea
- Discipline of Public Health & Primary Care, School of Medicine, Trinity College, Dublin, Ireland; Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland.
| | - Lydia O'Sullivan
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland; Health Research Board-Trials Methodology Research Network, College of Medicine, Nursing and Health Sciences, University of Galway, County Galway, Galway, Ireland
| | - Kirsty K O'Brien
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland
| | - Marie Carrigan
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland
| | - Susan Ahern
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland
| | - Maeve McGarry
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland
| | - Patricia Harrington
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland
| | - Kieran A Walsh
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland; School of Pharmacy, University College Cork, County Cork, Cork, Ireland
| | - Susan M Smith
- Discipline of Public Health & Primary Care, School of Medicine, Trinity College, Dublin, Ireland
| | - Máirín Ryan
- Health Technology Assessment Directorate, Health Information and Quality Authority, Cork, Ireland; Department of Pharmacology and Therapeutics, Trinity College, Dublin, Ireland
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Kim J, Lee S, Kim D, Kim HJ, Oh KT, Kim SJ, Choi YD, Giesel FL, Kopka K, Hoepping A, Lee M, Yun M. Combination of [ 18F]FDG and [ 18F]PSMA-1007 PET/CT predicts tumour aggressiveness at staging and biochemical failure postoperatively in patients with prostate cancer. Eur J Nucl Med Mol Imaging 2024; 51:1763-1772. [PMID: 38200396 DOI: 10.1007/s00259-023-06585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has limitations in prostate cancer (PCa) detection owing to low glycolysis in the primary tumour. Recently, prostate-specific membrane antigen (PSMA) PET/CT has been useful for biochemical failure detection and radioligand therapy (RLT) guidance. However, few studies have evaluated its use in primary prostate tumours using PSMA and [18F]FDG PET/CT. This study aimed to evaluate [18F]PSMA-1007 and [18F]FDG PET/CT for primary tumour detection and understand the association of metabolic heterogeneity with clinicopathological characteristics at staging and postoperatively. METHOD This prospective study included 42 index tumours (27 acinar and 15 ductal-dominant) in 42 patients who underwent [18F]PSMA-1007 and [18F]FDG PET/CT and subsequent radical prostatectomy. All patients were followed for a median of 26 mo, and serum prostate-specific antigen levels were measured every 3 mo to evaluate biochemical failure. One-way analysis of variance, Tukey's multiple comparison test, and Fisher's exact test were performed. RESULTS All 42 index tumours were detected on [18F]PSMA-1007 PET/CT, whereas only 15 were detected on [18F]FDG PET/CT (62.3% vs. 37.7%, p < 0.0001). A high SUVmax for [18F]PSMA-1007 was observed in tumours with high Gleason scores (GS 6-7 vs. GS 8-10; 12.1 vs. 20.1, p < 0.05). Tumours with [18F]FDG uptake were mostly ductal dominant (acinar-dominant 4/27; ductal-dominant; 11/15, p < 0.001), with lower [18F]PSMA-1007 uptake than tumours without [18F]FDG uptake (SUVmax 16.58 vs. 11.19, p < 0.001). There were 16.6% (7/42) of patients with pStage IV in whom the primary tumours were [18F]FDG positive. Biochemical failure was observed in 14.8% (4/27) of patients with [18F]FDG negative tumours but in 53.3% (8/15) of patients with [18F]FDG positive tumours (p = 0.013). CONCLUSIONS [18F]PSMA-1007 PET/CT was superior to [18F]FDG PET/CT in detecting primary PCa. In contrast, tumours with [18F]FDG uptake are associated with larger size, a ductal-dominant type, and likely to undergo metastasis at staging and biochemical failure postoperatively.
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Affiliation(s)
- Jisu Kim
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Seunghwan Lee
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dongwoo Kim
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Hyun Jeong Kim
- Department of Nuclear medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Kyeong Taek Oh
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Jung Kim
- Department of Nuclear Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Frederik L Giesel
- Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Klaus Kopka
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328, Dresden, Germany
| | - Alexander Hoepping
- ABX Advanced Biochemical Compounds GmbH, Heinrich-Glaeser-Strasse 10-14, 01454, Radeberg, Germany
| | - Misu Lee
- Division of Life Sciences, College of Life Science and Bioengineering, Incheon National University, Incheon, South Korea.
- Institute for New Drug Development, College of Life Science and Bioengineering, Incheon National University, Incheon, 22012, South Korea.
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, South Korea.
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Ali I, Rezk M, Hamouda D, Talaat O, Omar Y, Abdel Tawab M, Nasr I. Clinical value of 18F-PSMA-1007 PET/MRI in primary staging of patients with intermediate- to high-risk prostate cancer. Br J Radiol 2024; 97:622-631. [PMID: 38265254 PMCID: PMC11027301 DOI: 10.1093/bjr/tqae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To assess the utility of 18F-PSMA-1007 PET/MRI in initial staging of intermediate- to high-risk prostate cancer (HRPCa). METHODS A total of 46 patients with pathologically verified intermediate and/or HRPCa who underwent 18F-PSMA-1007 PET/MRI with dedicated pelvic high-resolution multiparametric MRI (mpMRI) were included. RESULTS PET/MRI showed 100% sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy in detecting seminal vesicle (SV) and rectal invasion, versus 87.5%, 100%, 100% 93.8%, 95.7% and 50%, 100%,100%, 95.5%, and 95.7% for mpMRI respectively. However, PET/MRI had poor SN (40% and 0%) but high SP (94.4% and 100%) in detection of UB and neurovascular bundle (NV) invasion compared to 100% SN and SP for mpMRI. PET/MRI demonstrated stronger TNM staging agreement with the gold standard than mpMRI-WBMRI. It demonstrated concordance with T, N, and M stages in 40, 41, and 36 patients (k 0.84, 0.60, and 0.68, respectively) versus 29, 33, and 31 patients (k 0.54, 0.22, and 0.50) with accurate over all staging of 38/46 patients versus 30/46 patients (K 0.52 versus 0.22). CONCLUSION 18F-PSMA-1007 PET/MRI is a promising imaging modality with high diagnostic accuracy in staging intermediate- and HRPCa; it improves local tumour evaluation and provides precise TNM staging. ADVANCES IN KNOWLEDGE 18F-PSMA-1007 PET/MRI could have high diagnostic accuracy as shown in the current study for staging HRPCa patients that is crucial for treatment selection. We think that our study will contribute to the body of knowledge and improve the literature surrounding the clinical uses of integrated 18F-PSMA-1007 PET/MRI.
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Affiliation(s)
- Ismail Ali
- Radiology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Faculty of medicine street, Zagazig, Sharkia, 44519, Egypt
| | - Mahmoud Rezk
- Radiology Department, National cancer Institute, Cairo University, Cairo, 11796, Egypt
| | - Dalia Hamouda
- Medical Oncology Department, Faculty of Human Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Omnia Talaat
- Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, 11796, Egypt
| | - Yehia Omar
- Director of PET/MRI unit, Misr Radiology Cente, Cairo, 11766, Egypt
| | - Mohamed Abdel Tawab
- Radiology Department, Faculty of Human Medicine, Alazhar University, Cairo, 11651, Egypt
| | - Ibrahim Nasr
- Clinical Oncology and Nuclear Medicine Department, Faculty of Human Medicine, Zagazig University, Zagazig, 44519, Egypt
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9
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Heetman JG, Hermsen R, Exterkate L, Küsters-Vandevelde HVN, Brouwer LJM, Somford DM, van den Bergh RCN, van Basten JPA. Immunohistochemical and histopathological validation of 18 F-PSMA-1007 PET/CT for intraprostatic cancerous lesions. Prostate 2023; 83:1332-1341. [PMID: 37455399 DOI: 10.1002/pros.24595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/02/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Prostate-specific membrane antigen (PSMA) is overexpressed in prostate cancer (PCa). In this study, we aim to immunohistochemically and histopathological validate the fluorine-18 (18 F)-PSMA-1007 positron emission tomography/computed tomography (PET/CT) for intraprostatic PCa lesions. METHODS Between February 2019 and October 2020, patients with biopsy-proven, treatment-naïve intermediate-to-high-risk PCa undergoing an 18 F-PSMA-1007 PET/CT before robot-assisted radical prostatectomy (RARP) were prospectively enrolled. For all PCa lesions found on whole-mount histopathology, location, size, International Society of Urological Pathology (ISUP) grade group (GG), and immune reactive score (IRS) were assessed after PSMA staining. ISUP GG ≥ 3 PCa was defined as clinically significant (cs) PCa. All lesions were matched on PSMA PET/CT and the maximum standardized uptake value (SUVmax) was measured. RESULTS A total of 125 lesions were analyzed in the 80 RARP specimens, of which 49 (40%) were csPCa and 76 (60%) non-csPCa. Linear multivariable regressions showed that an increase in SUVmax significantly correlated with a higher ISUP GG (p values between 0.021 and 0.001) and a higher IRS (p = 0.017). Logistic multivariable regression showed that csPCa significantly correlated with a higher SUVmax (odds ratio, OR: 1.17 [95% confidence interval, CI: 1.04-1.21, p = 0.005]), an increase in tumor length (OR: 1.05 [95% CI 1.01-1.10, p = 0.020]) and a higher IRS (OR; 1.24 [95% CI 1.07-1.47, p = 0.006]). A SUVmax threshold of 4 would have resulted in one (2%) missed lesion with csPCa. CONCLUSION This prospective study revealed that 18 F-PSMA-1007 PET/CT SUVmax is correlated with the ISUP GG and IRS, and thereby could be a tool to characterize intraprostatic PCa lesions.
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Affiliation(s)
- Joris G Heetman
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Rick Hermsen
- Department of Nuclear Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Leonie Exterkate
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | | | - Lenneke J M Brouwer
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | - Diederik M Somford
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | | | - Jean-Paul A van Basten
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
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10
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Jiang J, Chen L, Ji X, Zheng X, Hong J, Tang K, Zheng X. ( 18F)-PSMA-1007PET/CT in patients with biochemical recurrence after radical prostatectomy: Diagnostic performance and impact on treatment management. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2023; 5:100021. [PMID: 39076163 PMCID: PMC11265200 DOI: 10.1016/j.redii.2022.100021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/27/2022] [Indexed: 07/31/2024]
Abstract
Objective To evaluate the diagnostic performance of (18F)-PSMA-1007 PET/CT in prostate cancer patients with biochemical recurrence (BCR) after radical prostatectomy and the effect of (18F)-PSMA-1007 PET/CT on treatment strategy. Methods A total of 114 patients with BCR after radical prostatectomy who performed (18F)-PSMA-1007 PET/CT were retrospectively analyzed. The Gleason scores (GS), maximum standardized uptake values (SUVmax) and the diagnostic performance were compared according to different prostate-specific antigen (PSA) groups. To evaluate the impact of (18F)-PSMA-1007 PET/CT on treatment management, we also collected subjects' therapy before and after PET/CT. The PSA value was monitored to evaluate the biochemical response. Results (18F)-PSMA-1007PET/CT was positive in 92/114 patients (80.7%). The detection rates were 20/34 (58.8%), 13/17 (76.5%), 15/17 (88.2%) and 44/46 (95.7%) for PSA levels of 0.2-<0.5, 0.5-<1, 1-<2, ≥2 ng/ml. The positive lesions on PET/CT revealed local recurrence in 24/114 (21.1%) patients, lymph nodes metastases in 54/114 (47.4%) and metastatic sites in bone, lung, and others in 75/114 (65.8%). A significant positive correlation was observed between the GS/ SUVmax and PSA level (r1 = 0.375, r2 = 0.336, P<0.001). As a result of the (18F)-PSMA-1007 PET/CT, therapeutic decision-making changed in 60/114 (52.6%) patients. With a follow-up of 11.0 ± 6.4 months, 81/114 PSA were collected after treatment guided by (18F)-PSMA-1007 PET/CT, and in 42/81 (51.9%) of patients, serum PSA levels decreased of more than 60%. Conclusion (18F)-PSMA-1007 PET/CT has a high lesion detection rate for recurrent prostate cancer (PCa) and could have significant implications in decision-making treatment plan for the majority of PCa patients.
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Affiliation(s)
- Jia Jiang
- Radiological Imaging Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Lei Chen
- Radiological Imaging Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Xiaowei Ji
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Xuan Zheng
- Radiological Imaging Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Junjie Hong
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Xuefu North Rd, Wenzhou, Zhejiang, 325000, China
| | - Kun Tang
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Xiangwu Zheng
- Radiological Imaging Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Xuefu North Rd, Wenzhou, Zhejiang, 325000, China
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11
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Kim SB, Song IH, Kim SY, Ko HY, Kil HS, Chi DY, Giesel FL, Kopka K, Hoepping A, Chun JH, Park HS, Yun M, Kim SE. Preclinical Evaluation of a Companion Diagnostic Radiopharmaceutical, [ 18F]PSMA-1007, in a Subcutaneous Prostate Cancer Xenograft Mouse Model. Mol Pharm 2022; 20:1050-1060. [PMID: 36583623 PMCID: PMC9906735 DOI: 10.1021/acs.molpharmaceut.2c00788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Several radiolabeled prostate-specific membrane antigen (PSMA)-targeted agents have been developed for detecting prostate cancer, using positron emission tomography imaging and targeted radionuclide therapy. Among them, [18F]PSMA-1007 has several advantages, including a comparatively long half-life, delayed renal excretion, and compatible structure with α-/β-particle emitter-labeled therapeutics. This study aimed to characterize the preclinical pharmacokinetics and internal radiation dosimetry of [18F]PSMA-1007, as well as its repeatability and specificity for target binding using prostate tumor-bearing mice. In PSMA-positive tumor-bearing mice, the kidney showed the greatest accumulation of [18F]PSMA-1007. The distribution in the tumor attained its peak concentration of 2.8%ID/g at 112 min after intravenous injection. The absorbed doses in the tumor and salivary glands were 0.079 ± 0.010 Gy/MBq and 0.036 ± 0.006 Gy/MBq, respectively. The variance of the net influx (Ki) of [18F]PSMA-1007 to the tumor was minimal between scans performed in the same animals (within-subject coefficient of variation = 7.57%). [18F]PSMA-1007 uptake in the tumor was specifically decreased by 32% in Ki after treatment with a PSMA inhibitor 2-(phosphonomethyl)-pentanedioic acid (2-PMPA). In the present study, we investigated the in vivo preclinical characteristics of [18F]PSMA-1007. Our data from [18F]PSMA-1007 PET/computed tomography (CT) studies in a subcutaneous prostate cancer xenograft mouse model supports clinical therapeutic strategies that use paired therapeutic radiopharmaceuticals (such as [177Lu]Lu-PSMA-617), especially strategies with a quantitative radiation dose estimate for target lesions while minimizing radiation-induced toxicity to off-target tissues.
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Affiliation(s)
- Su Bin Kim
- Department
of Applied Bioengineering, Graduate School of Convergence Science
and Technology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul08826, Korea,Department
of Nuclear Medicine, Seoul National University
College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173
Beon-gil, Bundang-gu, Seongnam13620, Korea
| | - In Ho Song
- Department
of Nuclear Medicine, Seoul National University
College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173
Beon-gil, Bundang-gu, Seongnam13620, Korea
| | - Seon Yoo Kim
- Department
of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul03722, Korea
| | - Hae Young Ko
- Department
of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul03722, Korea
| | - Hee Seup Kil
- Research
Institute of Radiopharmaceuticals, FutureChem
Co. Ltd, Seoul04793, Korea
| | - Dae Yoon Chi
- Research
Institute of Radiopharmaceuticals, FutureChem
Co. Ltd, Seoul04793, Korea
| | - Frederik L. Giesel
- Department
of Nuclear Medicine, Heinreich-Heine-University,
University Hospital Duesseldorf, Duesseldorf40225, Germany
| | - Klaus Kopka
- Institute
of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR) e.v., Bautzner Landstrasse 400, Dresden01328, Germany,Technische
Universität Dresden, Faculty of Chemistry and Food Chemistry,
School of Science, Dresden01069, Germany,National
Center for Tumor Diseases (NCT) Dresden, University Hospital Carl Gustav Carus, Fetscherstraße 74, Dresden01307, Germany,German
Cancer Consortium (DKTK), Partner Site Dresden, Dresden01307, Germany
| | - Alexander Hoepping
- Department
of Medicinal Chemistry, ABX Advanced Biochemical
Compounds GmbH, Radeberg1454, Germany
| | - Joong-Hyun Chun
- Department
of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul03722, Korea
| | - Hyun Soo Park
- Department
of Nuclear Medicine, Seoul National University
College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173
Beon-gil, Bundang-gu, Seongnam13620, Korea,Department
of Molecular Medicine and Biopharmaceutical Sciences, Graduate School
of Convergence Science and Technology, Seoul
National University, 1 Gwanak-ro, Gwanak-gu, Seoul08826, Korea,. Tel: +82-31-787-2936. Fax: +82-31-787-4018
| | - Mijin Yun
- Department
of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul03722, Korea,. Tel: +82-2-2228-6068. Fax: +82-2-2227-8354
| | - Sang Eun Kim
- Department
of Nuclear Medicine, Seoul National University
College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173
Beon-gil, Bundang-gu, Seongnam13620, Korea,Department
of Molecular Medicine and Biopharmaceutical Sciences, Graduate School
of Convergence Science and Technology, Seoul
National University, 1 Gwanak-ro, Gwanak-gu, Seoul08826, Korea,Advanced
Institutes of Convergence Technology, 145 Gwanggyo-ro, Yeongtong-gu, Suwon16229, Korea,BIK Therapeutics Inc., 172 Dolma-ro, Bundang-gu, Seongnam13605, Korea,. Tel: +82-31-787-7671. Fax: +82-31-787-4018
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12
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Dong S, Li Y, Chen J, Li Y, Yang P, Li J. 18F-PSMA-1007 PET/CT-derived semi-quantitative parameters for risk stratification of newly diagnosed prostate cancer. Front Oncol 2022; 12:1025930. [PMID: 36568229 PMCID: PMC9768475 DOI: 10.3389/fonc.2022.1025930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose This study aimed to assess the value of 18F-PSMA-1007 positron emission tomography/computed tomography (PET/CT)-derived semi-quantitative parameters of primary tumor for risk stratification of newly diagnosed prostate cancer (PCa). Methods Sixty patients referred for 18F-PSMA-1007 PET/CT imaging for primary PCa were retrospectively analyzed and classified into the low-intermediate-risk (LIR) or high-risk (HR) group. The maximum standardized uptake value (SUVmax) of primary tumor, prostate total lesion PSMA (TL-PSMAp), and prostate PSMA-tumor volume (PSMA-TVp) were measured, and group differences were evaluated using the Mann-Whitney U test. Spearman's correlation was performed to assess the correlation between the above parameters with prostate-specific antigen (PSA) levels and Gleason score (GS). Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for SUVmax, TL-PSMAp, and PSMA-TVp to identify high-risk PCa and compare diagnostic efficacy. Results Among 60 patients, 46 were assigned to the HR group and 16 to the LIR group. In all patients, SUVmax, TL-PSMAp, and PSMA-TVp were moderately correlated with pre-treatment PSA values (r = 0.411, p = 0.001; r = 0.663, p < 0.001; and r = 0.549, p < 0.001, respectively). SUVmax and TL-PSMAp were moderately correlated with GS (r = 0.457 and r = 0.448, respectively; p < 0.001), while PSMA-TVp was weakly correlated with GS (r = 0.285, p = 0.027). In the ROC curve analysis, the optimal cut-off values of SUVmax, TL-PSMAp, and PSMA-TVp for identifying high-risk PCa were 9.61, 59.62, and 10.27, respectively, and the areas under the operating curve were 0.828, 0.901, and 0.809, respectively. The sensitivities of SUVmax, TL-PSMAp, and PSMA-TVp were 91.03%, 71.74%, and 63.04%, respectively, and the specificities were 71.43%, 100.00%, and 92.86%, respectively. Conclusions TL-PSMAp had a superior ability to identify high-risk PCa. The semi-quantitative parameters of primary tumor on 18F-PSMA-1007 PET/CT imaging can be an objective imaging reference index to determine PCa risk stratification.
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Affiliation(s)
- Siying Dong
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China,College of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Yanmei Li
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China,*Correspondence: Juan Li, ; Yanmei Li,
| | - Jian Chen
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China,College of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Yongliang Li
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China,College of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Pengfei Yang
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Juan Li
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, China,*Correspondence: Juan Li, ; Yanmei Li,
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13
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Huang YT, Tseng NC, Chen YK, Huang KH, Lin HY, Huang YY, Hwang TIS, Ou YC. The Detection Performance of 18 F-Prostate-Specific Membrane Antigen-1007 PET/CT in Primary Prostate Cancer : A Systemic Review and Meta-analysis. Clin Nucl Med 2022; 47:755-762. [PMID: 35452013 DOI: 10.1097/rlu.0000000000004228] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Multiple tools are now available to determine the requirement for a biopsy to diagnose prostate cancer, and PET/CT with radiolabeled prostate-specific membrane antigen (PSMA)-targeting radiotracers has been recommended for detecting primary prostate cancer. Particularly, the radiotracer 18 F-PSMA-1007 was found to be more favorable for primary tumors compared with other PSMA-targeting radiotracers because of its low clearance via the urinary tract and better image resolution. Thus, we performed a systematic review and meta-analysis to more accurately evaluate the detection performance of 18 F-PSMA-1007 PET/CT in primary prostate cancer patients. METHODS An update on the databases of PubMed/MEDLINE, EMBASE, and Cochrane Library for comprehensive literature search was performed on September 30, 2021. The pooling detection rate was calculated on a per-patient basis. The pooling median of the SUV max was analyzed from the included studies. Furthermore, the positive predictive value of 18 F-PSMA-1007 PET/CT with pathologic lesions was analyzed using the criterion standard. RESULTS Twelve studies (540 patients total) were included in the meta-analysis. The overall pooling detection rate of 18 F-PSMA-1007 per patient was 94%, and the pooling median of SUV max located at the intraprostate tumor was 16 (range, 3.7-77.7). The positive predictive value of 18 F-PSMA-1007 per lesion with histopathological validation was 0.90, detecting regional lymph node metastasis was 0.94, and detecting localized prostatic tumors was 0.84. CONCLUSIONS In the current meta-analysis, we revealed the excellent performance of 18 F-PSMA-1007 to detect localized prostatic tumor lesions and regional lymph node metastasis. Moreover, the uptake of localized tumors in primary prostate cancer was nearly liver uptake and may be considered a suspicious malignancy if it was equal to or greater than the liver uptake.
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14
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Zschaeck S, Andela SB, Amthauer H, Furth C, Rogasch JM, Beck M, Hofheinz F, Huang K. Correlation Between Quantitative PSMA PET Parameters and Clinical Risk Factors in Non-Metastatic Primary Prostate Cancer Patients. Front Oncol 2022; 12:879089. [PMID: 35530334 PMCID: PMC9074726 DOI: 10.3389/fonc.2022.879089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background PSMA PET is frequently used for staging of prostate cancer patients. Furthermore, there is increasing interest to use PET information for personalized local treatment approaches in surgery and radiotherapy, especially for focal treatment strategies. However, it is not well established which quantitative imaging parameters show highest correlation with clinical and histological tumor aggressiveness. Methods This is a retrospective analysis of 135 consecutive patients with non-metastatic prostate cancer and PSMA PET before any treatment. Clinical risk parameters (PSA values, Gleason score and D'Amico risk group) were correlated with quantitative PET parameters maximum standardized uptake value (SUVmax), mean SUV (SUVmean), tumor asphericity (ASP) and PSMA tumor volume (PSMA-TV). Results Most of the investigated imaging parameters were highly correlated with each other (correlation coefficients between 0.20 and 0.95). A low to moderate, however significant, correlation of imaging parameters with PSA values (0.19 to 0.45) and with Gleason scores (0.17 to 0.31) was observed for all parameters except ASP which did not show a significant correlation with Gleason score. Receiver operating characteristics for the detection of D'Amico high-risk patients showed poor to fair sensitivity and specificity for all investigated quantitative PSMA PET parameters (Areas under the curve (AUC) between 0.63 and 0.73). Comparison of AUC between quantitative PET parameters by DeLong test showed significant superiority of SUVmax compared to SUVmean for the detection of high-risk patients. None of the investigated imaging parameters significantly outperformed SUVmax. Conclusion Our data confirm prior publications with lower number of patients that reported moderate correlations of PSMA PET parameters with clinical risk factors. With the important limitation that Gleason scores were only biopsy-derived in this study, there is no indication that the investigated additional parameters deliver superior information compared to SUVmax.
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Affiliation(s)
- Sebastian Zschaeck
- Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany
| | - Stephanie Bela Andela
- Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Furth
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julian M. Rogasch
- BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus Beck
- Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank Hofheinz
- PET Center, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Kai Huang
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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15
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Comparison of [ 18F]PSMA-1007 with [ 68Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse. Cancers (Basel) 2022; 14:cancers14061479. [PMID: 35326629 PMCID: PMC8946234 DOI: 10.3390/cancers14061479] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 12/31/2022] Open
Abstract
This study aimed to compare the diagnostic performance of [18F]PSMA-1007 positron emission tomography/computed tomography (PET/CT) (18F-PSMA) and [68Ga]Ga-PSMA-11 PET/CT (68Ga-PSMA) by identifying prostate-specific antigen (PSA) threshold levels for optimal detecting recurrent prostate cancer (PC) and to compare both methods. Retrospectively, the study included 264 patients. The performances of 18F-PSMA and 68Ga-PSMA in relation to the pre-scan PSA were assessed by receiver operating characteristic (ROC) curve. 18F-PSMA showed PC-lesions in 87.5% (112/128 patients), while 68Ga-PSMA identified them in 88.9% (121/136). For 18F-PSMA biochemical recurrent (BCR) patients treated with radical prostatectomy (78/128, patient group: F-RP), a PSA of 1.08 ng/mL was found to be the optimal cut-off level for predicting positive and negative scans (AUC = 0.821; 95%, CI: 0.710−0.932), while for prostatectomized 68Ga-PSMA BCR-patients (89/136, patient group: Ga-RP), the cut-off was 1.84 ng/mL (AUC = 0.588; 95%, CI: 0.410−0.766). In patients with PSA < 1.08 ng/mL (F-RP) 76.3% and <1.84 ng/mL (Ga-RP) 78.6% scans were positive, whereas patients with PSA ≥ 1.08 ng/mL (F-RP) or 1.84 ng/mL (Ga-RP) had positive scan results in 100% and 91.5% (p < 0.001/p = 0.085). The identified PSA thresholds for PSMA-mappable PC lesions in BCR-patients (RP) showed a better separation for 18F-PSMA with regard to the distinguishing of positive and negative PC-lesions compared to 68Ga-PSMA. However, the two PSMA PET/CT tracers gave similar overall findings.
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Rosenzweig B, Haramaty R, Davidson T, Lazarovich A, Shvero A, Haifler M, Gal J, Golan S, Shpitzer S, Hoffman A, Nativ O, Freifeld Y, Zreik R, Dotan ZA. Very Low Prostate PET/CT PSMA Uptake May Be Misleading in Staging Radical Prostatectomy Candidates. J Pers Med 2022; 12:jpm12030410. [PMID: 35330410 PMCID: PMC8951096 DOI: 10.3390/jpm12030410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: to evaluate a unique subpopulation of radical prostatectomy (RP) candidates with “negative” prostate 68Ga-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT) imaging scans and to characterize the clinical implications of misleading findings. Materials and Methods: This case-control retrospective study compared the final histological outcomes of patients with “negative” pre-RP PSMA PET/CT prostate scans (with a prostate maximal standardized uptake value [SUVmax] below the physiologic uptake) to those with an “intense” prostatic tracer uptake (with a SUVmax above the physiologic uptake). The patients underwent an RP between March 2015 and July 2019 in five academic centers. Data on the demographics, comorbidities, prostate-specific antigen (PSA) and rectal exam findings, prior biopsies, imaging results, biopsies, and RP histology results were collected. Results: Ninety-seven of the 392 patients who underwent an RP had PSMA PET/CT imaging preoperatively. Fifty-two (54%) had a “negative” uptake (in the study group), and 45 (46%) had a “positive” uptake (in the control group). Only the lesion size and SUVmax values on the PSMA PET/CT differed between the groups preoperatively. On the histological analysis, only the ISUP score, seminal vesicles invasion, T stage, and positive margin rates differed between the groups (p < 0.05), while 50 (96%) study group patients harbored clinically significant disease (ISUP ≥ 2), with an extra-prostatic disease in 24 (46%), perineural invasion in 35 (67%), and positive lymph nodes in 4 (8%). Conclusions: Disease aggressiveness generally correlated with an intense PSMA uptake on the preoperative PSMA PET/CT, but a subpopulation of patients with clinically significant cancer and aggressive characteristics showed a deceptively weak PSMA uptake. These data raise a concern about the unqualified application of PSMA PET/CT for staging RP candidates.
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Affiliation(s)
- Barak Rosenzweig
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Correspondence: ; Tel.: +972-3-5302221
| | - Rennen Haramaty
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Tima Davidson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Nuclear Medicine, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel
| | - Alon Lazarovich
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Asaf Shvero
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
| | - Miki Haifler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Jonathan Gal
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Shay Golan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Sagi Shpitzer
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Azik Hoffman
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Omri Nativ
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
| | - Yuval Freifeld
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
- Department of Urology, Carmel Medical Center, Haifa 3436212, Israel
| | - Rani Zreik
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Zohar A. Dotan
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
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Yadav D, Hwang H, Qiao W, Upadhyay R, Chapin BF, Tang C, Aparicio A, Lopez-Olivo MA, Kang SK, Macapinlac HA, Bathala TK, Surasi DS. 18F-Fluciclovine versus PSMA PET Imaging in Primary Tumor Detection during Initial Staging of High-Risk Prostate Cancer: A Systematic Review and Meta-Analysis. Radiol Imaging Cancer 2022; 4:e210091. [PMID: 35212559 PMCID: PMC8965534 DOI: 10.1148/rycan.210091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/28/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
Purpose Fluorine 18 (18F)-fluciclovine and prostate-specific membrane antigen (PSMA) tracers are commonly used for localizing biochemical recurrence of prostate cancer, but their accuracy in primary tumor detection in the initial staging of high-risk prostate cancer has not been established. Materials and Methods A systematic review was performed of the electronic databases for original studies published between 2012 and 2020. Included studies were those in which 18F-fluciclovine or PSMA PET was used for initial staging of patients with high-risk prostate cancer. The diagnostic performance data were collected for primary tumor with histopathologic results as reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used for quality appraisal. A random-effects model was used to summarize the effect sizes and to evaluate the difference between two groups. Results Overall, 28 studies met the eligibility criteria, and 17 were included in the meta-analysis (18F-fluciclovine = 4, PSMA = 13). Of these 17 studies, 12 (70%) were judged to have high risk of bias in one of the evaluated domains, and nine studies were deemed to have applicability concerns. The pooled sensitivity, specificity, and diagnostic odds ratio for 18F-fluciclovine versus PSMA were 85% (95% CI: 73%, 92%) versus 84% (95% CI: 77%, 89%) (P = .78), 77% (95% CI: 60%, 88%) versus 83% (95% CI: 76%, 89%) (P = .40), and 18.88 (95% CI: 5.01, 71.20) versus 29.37 (95% CI: 13.35, 64.60) (P = .57), respectively, with no significant difference in diagnostic test accuracy. Conclusion 18F-fluciclovine and PSMA PET demonstrated no statistically significant difference in diagnostic accuracy in primary tumor detection during initial staging of high-risk prostate cancer. Keywords: PET, Prostate, Molecular Imaging-Cancer, Staging Supplemental material is available for this article. © RSNA, 2022.
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Affiliation(s)
- Divya Yadav
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Hyunsoo Hwang
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Wei Qiao
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Rituraj Upadhyay
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Brian F. Chapin
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Chad Tang
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Ana Aparicio
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Maria A. Lopez-Olivo
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Stella K. Kang
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Homer A. Macapinlac
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Tharakeswara K. Bathala
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
| | - Devaki Shilpa Surasi
- From the Departments of Radiation Oncology (D.Y., R.U., C.T.),
Biostatistics (H.H., W.Q.), Urology (B.F.C.), Genitourinary Medical Oncology
(A.A.), Health Services Research (M.A.L.O.), Nuclear Medicine (H.A.M., D.S.S.),
and Abdominal Imaging (T.K.B.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 483, Houston, TX 77030; and Department of
Radiology, NYU Langone Health, New York, NY (S.K.K.)
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Diagnostic value of integrated 18F-PSMA-1007 PET/MRI Compared with that of Biparametric MRI for the detection of Prostate Cancer. Prostate Int 2022; 10:108-116. [PMID: 35510079 PMCID: PMC9052074 DOI: 10.1016/j.prnil.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/09/2022] [Accepted: 03/22/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Materials and methods Results Conclusion
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19
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Risk of metastatic disease using [ 18F]PSMA-1007 PET/CT for primary prostate cancer staging. EJNMMI Res 2021; 11:128. [PMID: 34928437 PMCID: PMC8688644 DOI: 10.1186/s13550-021-00869-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/14/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Accurate prostate cancer imaging is critical for patient management. Multiple studies have demonstrated superior diagnostic accuracy of [68Ga]-PSMA-11 PET/CT over conventional imaging for disease detection, with validated clinical and biochemical predictors of disease detection. More recently [18F]PSMA-1007 offers theoretical imaging advantages, but there is limited evidence of clinical and biochemical predictors of scan findings in the staging population. This study investigates the association of clinical variables with imaging characteristics among patients who underwent [18F]PSMA-1007 PET/CT for primary staging of men with histopathologically confirmed prostate carcinoma. A retrospective review of 194 consecutive patients imaged between May 2019 to May 2020 was performed. Association between imaging variables (presence and distribution of metastatic disease, primary tumour SUVmax) and clinical variables (EAU risk criteria) were assessed using descriptive statistics, logistic regression model and ROC analysis. RESULTS The median age, PSA level and ISUP grade were 70 years, 10 ng/mL and ISUP grade 3, respectively. There were 36.6% of patients with intermediate-risk and 60.8% of patients with high-risk disease. ISUP grade was associated with the presence of metastasis overall (p = 0.008) as well as regional nodal (p = 0.003), non-regional nodal (p = 0.041) and bone (p = 0.006) metastases. PSA level was associated with metastatic disease overall (p = 0.001), regional (p = 0.001) and non-regional nodal metastases (p = 0.004), but not with bone metastases (p = 0.087). There were too few visceral metastases for meaningful analysis. SUVmax of the primary prostatic tumour was associated with ISUP grade (p = 0.004), PSA level (p < 0.001) and AJCC stage (p = 0.034). PSA > 20 ng/mL and ISUP grade > 3 had a specificity of 85% (95% CI 78-91%) and 60% (95% CI 50-68%) and a sensitivity of 36% (95% CI 25-49%) and 62% (95% CI 49-74%), respectively, for detection of metastatic disease. CONCLUSION Metastatic disease according to [18F]PSMA-1007 PET/CT was associated with ISUP grade and PSA level. This is the largest study using [18F]PSMA-1007 PET/CT to confirm a positive correlation of PSA level, ISUP grade and stage with primary prostate tumour SUVmax.
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Awenat S, Piccardo A, Carvoeiras P, Signore G, Giovanella L, Prior JO, Treglia G. Diagnostic Role of 18F-PSMA-1007 PET/CT in Prostate Cancer Staging: A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11030552. [PMID: 33808825 PMCID: PMC8003688 DOI: 10.3390/diagnostics11030552] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of 18F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting. Methods: A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using 18F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently. Results: Eight articles (369 patients) evaluating the role of 18F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher 18F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, 18F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. 18F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and 18F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, 18F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging. Conclusions: 18F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.
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Affiliation(s)
- Salam Awenat
- Institute for Radiology and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, 44892 Bochum, Germany;
| | - Arnoldo Piccardo
- Department of Nuclear Medicine, E.O. Ospedali Galliera, 16128 Genoa, Italy;
| | | | - Giovanni Signore
- Department of Medicine, Università degli studi della Campania “L. Vanvitelli”, 81100 Caserta, Italy;
| | - Luca Giovanella
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland;
- Department of Nuclear Medicine, University Hospital Zürich and University of Zürich, 8091 Zürich, Switzerland
| | - John O. Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland;
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland
- Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Correspondence: ; Tel.: +0041-918118919
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