Significance of metabolic tumor volume and total lesion uptake measured using Ga-68 labelled prostate-specific membrane antigen PET/CT in primary staging of prostate cancer.
Urol Oncol
; 40(9): 408.e19-408.e25, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-35902300
ABSTRACT
OBJECTIVE:
To evaluate the accuracy of Ga-68 prostate-specific membrane antigen positron-emission-tomography and computed-tomography(PSMA-PET/CT) in primary nodal staging of prostate cancer (PCa), and the predictive value of volumetric parameters derived from Ga-68- PSMA-PET/CT data in lymph node(LN) metastasis and correlation with histopathological and surgical outcomes. MATERIALS ANDMETHODS:
Seventy-seven patients with newly diagnosed, biopsy-proven PCa who underwent Ga-68-PSMA-PET/CT for primary staging of disease and underwent radical prostatectomy with extendend pelvic LN dissection were evaluated retrospectively. 2 experienced nuclear medicine specialists have retrospectively reviewed PET/CT images blinded to all histopathological and clinical data. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) for the detection of LN metastases were analyzed per-patient. Volumetric and semiquantitative PET parameters of the primary prostate lesions including SUVmax,metabolic tumor volume(MTV), and total lesion uptake(TLU) were measured and recorded.RESULTS:
Primary tumor SUVmax, MTV and TLU were found significantly higher in patients who were in higher ISUP Grade groups 3,4,5 after surgical treatment (Pâ¯=â¯0.021,Pâ¯=â¯0.049,Pâ¯=â¯0.032, respectively). The sensitivity, specificity, PPV and NPV on LN metastasis detection of Ga-68-PSMA-PET/CT was found 60%, 91%, 82% and 78% respectively. Although the distribution of the measured primary tumor MTV and TLU values were higher in histopathologically proven LN metastasis positive patients compared to negative patients, only TLU was statistically significant(Pâ¯=â¯0.023). Increase in primary tumor TLU values were correlated with higher pT stages and surgical margin positivity(Pâ¯=â¯0.034).CONCLUSION:
Ga-68-PSMA-PET/CT is of clinically valuable for primary staging. Measuring and adding these 2 parameters in routine clinical evaluation may increase the prediction power of high-grade disease confirmed by surgery.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
Urol Oncol
Assunto da revista:
NEOPLASIAS
/
UROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article