Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma

Cancers

Tim Holland-Letz¹  Stefanie Zschaebitz²  Dirk Jaeger²  FrederikL. Giesel³  Clemens Kratochwil³  Erik Winter³  Uwe Haberkorn³  Johannes Boesch³  StefanA. Koerber⁴  Juergen Debus⁴  Ingmar Schlampp⁴  Klaus Herfarth⁴  Jonas Ristau⁴  Luisa Hofer⁵  Markus Hohenfellner⁵  Klaus Kopka⁶ 

[1] Department of Biostatistics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany;Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany;Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany;Department of Urology, Heidelberg University Hospital, 69120 Heidelberg, Germany;German Cancer Consortium (DKTK), Partner Site Dresden, 01328 Dresden, Germany;

关键词: prostate cancer;    PSMA;    PET;    metastases;    intraprostatic SUV;   

DOI  :  10.3390/cancers13071508

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown