Evaluation of a radiomics nomogram derived from Fluoride-18 PSMA-1007 PET/CT for risk stratification in newly diagnosed prostate cancer

Abstract

ObjectiveThe aim of this study was to evaluate the performance of Fluoride-18 (18F)-PSMA-1007-PET/CT radiomics for the tumor malignancy and clinical risk stratification in primary prostate cancer (PCa).Materials and MethodsA total of 161 pathological proven PCa patients in a single center were retrospectively analyzed. Prostate-specific antigen (PSA), Gleason Score (GS) and PET/CT indexes (SUVmin, SUVmax, and SUVmean) were compared according to risk stratification. Radiomics features were extracted from PCa 18F-PSMA-1007-PET/CT imaging. The radiomics score integrating all selected parameters and clinicopathologic characteristics was used to construct a binary logistic regression and nomogram classifier. Predictors contained in the individualized prediction nomogram included radiomics score, PSA level and metastasis status.ResultsThe radiomics signature, which consisted of 30 selected features, was significantly associated with PSA level and Gleason score (P < 0.001 for both primary and validation cohorts). Predictors contained in the individualized prediction nomogram included radiomics score, PSA level and metastasis status. The model showed good discrimination with an area under the ROC curve of 0.719 for the GS. Combined clinical-radiomic score nomogram had a similar benefit to utilizing the PET/CT radiomic features alone for GS discrimination.ConclusionThe 18F-PSMA-1007-PET/CT radiomics signature can be used to facilitate preoperative individualized prediction of GS; incorporating the radiomics signature, PSA level, and metastasis status had similar benefits to those of utilizing the PET/CT radiomics features alone.

Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography-Derived Radiomic Models in Prostate Cancer Prognostication

“…Table 2 illustrates five studies utilizing PSMA PET/CT-derived radiomic models in PC staging [8,[22][23][24][25]. Three studies [22,24,25] (66.7%) utilized 68-Ga-PSMA-11 imaging and two [8,23] (33.3%) utilized Fluoride-18-PSMA-11 imaging alterations and biopsy Gleason score [25].…”

“…Among these is the prostate-specific Cancers 2024, 16, 1897 2 of 11 membrane antigen (PSMA) positron emission imaging and computerized tomography (PET/CT), which was approved by the Food and Drug Administration (FDA) in December 2020 and May 2021 for use with 68-Gallium (68-Ga) and piflufolastat (F18) in PC patients, respectively [4]. Since then, several systematic reviews have confirmed the PSMA PET/CT to more accurately detect the extent of disease [5], lymph node involvement [6,7], and distant metastases in patients newly diagnosed with PC [5,7,8].…”

Editorial: Opportunities for PET imaging for the identification, staging, and monitoring of cancers

“…extracted radiomics features from 18 F-PSMA-1007-PET/CT imaging of primary prostate cancer to predict the tumor malignancy and clinical risk stratification. The study showed that PET/CT radiomic features alone had similar benefits as combined prostate specific antigen levels and metastatic status ( 4 ). Zhou et al.…”

Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives

“…It can extract multiple features from pathological findings and potentially define new markers of disease [183][184][185]. Radiomics has the potential to further increase the value of imaging in PC management; nevertheless, its introduction into current clinical practice is full of questions, as emphasized by several radiomic studies [186][187][188][189]. Several approaches have been proposed and standardization is the major issue.…”