Diagnostic Performance of 11C-choline PET/CT and FDG PET/CT in Prostate Cancer

Ability of 68 Ga‐PSMA PET / CT SUVmax to differentiate ISUP GG2 from GG3 in intermediate‐risk prostate cancer: A single‐center retrospective study of 147 patients

OBJECTIVE

To evaluate the ability of ⁶⁸ Ga-PSMA PET/CT maximum standard uptake value (SUVmax) to distinguish prostate cancer (PCa) International Society of Urological Pathology ISUP grade group (GG) 2 and GG3.

METHODS

The PET/CT images and data of 147 patients were analyzed retrospectively, and the SUVmax of the index lesions were measured. The receiver operating characteristic curve was used to analyze the diagnostic value of PET/CT for PCa. The correlation between SUVmax and ISUP GG was analyzed. A logistic regression model was established with SUVmax and was validated to predict its value of diagnosing intermediate- and high-risk PCa (ihPCa).

RESULTS

Of the 147 patients, 112 cases were PCa (76.2%), and 35 cases were benign lesions (23.8%). There was a significant difference between the benign and the malignant groups (p < 0.05). The median SUVmax of ihPCa was significantly higher than that of the benign and low-risk groups (p < 0.05). The median SUVmax of GG3 was significantly higher than that of the GG2 group (p < 0.05). There were no statistically significant SUVmax differences among GG3, GG4, and GG5 groups (p > 0.05). The specificity and the positive predictive value of ⁶⁸ Ga-PSMA PET/CT in the diagnosis of PCa were 97% and 99% with cut-off SUVmax of 6.94, while the specificity and the positive predictive value of ihPCa were 95% and 96% with cut-off SUVmax of 10.12.

CONCLUSION

⁶⁸ Ga-PSMA PET/CT can reliably distinguish GG2 from GG3 PCa.

The Prognostic Value and Mechanisms of TMEM16A in Human Cancer

As a calcium ion-dependent chloride channel transmembrane protein 16A (TMEM16A) locates on the cell membrane. Numerous research results have shown that TMEM16A is abnormally expressed in many cancers. Mechanically, TMEM16A participates in cancer proliferation and migration by affecting the MAPK and CAMK signaling pathways. Additionally, it is well documented that TMEM16A exerts a regulative impact on the hyperplasia of cancer cells by interacting with EGFR in head and neck squamous cell carcinoma (HNSCC), an epithelial growth factor receptor in head and neck squamous cell carcinoma respectively. Meanwhile, as an EGFR activator, TMEM16A is considered as an oncogene or a tumor-promoting factor. More and more experimental data showed that down-regulation of TMEM16A or gene targeted therapy may be an effective treatment for cancer. This review summarized its role in various cancers and research advances related to its clinical application included treatment and diagnosis.

Morphometric vertebral fractures in patients with castration-resistant prostate cancer undergoing treatment with radium-223: a longitudinal study in the real-life clinical practice

PURPOSE

Radium-223 was associated with high incidence of non-vertebral fractures in patients with castration-resistant prostate cancer (CRPC). However, it is still unclear whether radium-223 may induce skeletal fragility regardless of other therapies for CRPC. We aimed at evaluating the prevalence, incidence, and determinants of vertebral fractures (VFs), i.e., the most frequent complication of skeletal fragility, in CRCP patients undergoing radium-223 therapy in the real-life clinical practice.

METHODS

We retrospectively reviewed 49 CRPC patients with symptomatic bone metastases treated with radium-223. Patients received median number of four radium-223 doses (range: 2-6) and were followed-up for a median period of 11 months (range: 6-44). VFs were assessed by a quantitative morphometry using lateral images of spine 11C-Choline PET/CT, excluding from the analysis the vertebral bodies affected by bone metastases.

RESULTS

Before radium-223 administration, 24 patients (49%) had VFs significantly associated with duration of androgen deprivation therapy (ADT; odds ratio 1.29) and previous abiraterone therapy (odds ratio 3.80). During radium-223 therapy, incident VFs occurred in 25% of patients, in relationship with prevalent VFs (hazard ratio 6.89) and change in serum total alkaline phosphatase values (hazard ratio 0.97), whereas the correlations with ADT and abiraterone therapy were lost. Noteworthy, the risk of VFs did not correlate with the therapeutic end points of radium-223.

CONCLUSIONS

This study provides a first evidence that in real-life clinical practice, radium-223 therapy may induce skeletal fragility with high risk of VFs, likely by inhibition of bone formation and independently of ADT and abiraterone therapy.