Journal Article

DKFZ-2021-00794

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Predicting the Risk of Metastases by PSMA-PET/CT-Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma.

Koerber, S. A. ; Boesch, J. ; Kratochwil, C.DKFZ* ; Schlampp, I. ; Ristau, J. ; Winter, E. ; Zschaebitz, S. ; Hofer, L. ; Herfarth, K. ; Kopka, K.DKFZ* ; Holland-Letz, T.DKFZ* ; Jaeger, D. ; Hohenfellner, M. ; Haberkorn, U.DKFZ* ; Debus, J.DKFZ* ; Giesel, F. (Last author)DKFZ*

2021
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/cancers13071508

Abstract: 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; p < 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.

Keyword(s): PET ; PSMA ; intraprostatic SUV ; metastases ; prostate cancer

Note: #LA:E060#

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Contributing Institute(s):

1. E060 KKE Nuklearmedizin (E060)
2. DKTK DD zentral (DD01)
3. C060 Biostatistik (C060)
4. DKTK HD zentral (HD01)
5. E050 KKE Strahlentherapie (E050)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2021

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