AUTHOR=Dong Siying , Li Yanmei , Chen Jian , Li Yongliang , Yang Pengfei , Li Juan 

TITLE=18F-PSMA-1007 PET/CT-derived semi-quantitative parameters for risk stratification of newly diagnosed prostate cancer

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1025930

DOI=10.3389/fonc.2022.1025930

ISSN=2234-943X

ABSTRACT=<sec><title>Purpose</title><p>This study aimed to assess the value of <sup>18</sup>F-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).</p></sec><sec><title>Methods</title><p>Sixty patients referred for <sup>18</sup>F-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.</p></sec><sec><title>Results</title><p>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 (<italic>r</italic> = 0.411, <italic>p</italic> = 0.001; <italic>r</italic> = 0.663, <italic>p</italic> &lt; 0.001; and <italic>r</italic> = 0.549, <italic>p</italic> &lt; 0.001, respectively). SUVmax and TL-PSMAp were moderately correlated with GS (<italic>r</italic> = 0.457 and <italic>r</italic> = 0.448, respectively; <italic>p</italic> &lt; 0.001), while PSMA-TVp was weakly correlated with GS (<italic>r</italic> = 0.285, <italic>p</italic> = 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.</p></sec><sec><title>Conclusions</title><p>TL-PSMAp had a superior ability to identify high-risk PCa. The semi-quantitative parameters of primary tumor on <sup>18</sup>F-PSMA-1007 PET/CT imaging can be an objective imaging reference index to determine PCa risk stratification.</p></sec>