Is there a correlation between Gleason score and maximum standardized uptake value in locally advanced prostate cancer patients?

Abstract

68 Background: The aim was to assess the intensity of 68Ga-PSMA uptake in the primary tumour in patients locally advanced prostate cancer treated with definitive radiotherapy. Also correlation between the maximum standardized uptake value (SUVmax) of primary tumour and the Gleason score (GS) or prostate-specific antigen (PSA) level was assessed. Methods: The data of 201 biopsy-proven prostated cancer patients were retrospectively analysed. Median age of entire cohort was 68 years (range; 45 – 85 years). PET/CT images were analysed visually and semiquantitatively by measuring the SUVmax. The SUVmax of the primary tumour was assessed in relation to both PSA level and GS. Results: Median age of entire cohort was 68 years (ranged 45 – 85 years). Median PSA value at diagnosis was 20.3 ng/mL (ranged 2.1 – 301.0 ng/mL). Forty-two patients (23.9%) was in intermediate risk group, and 159 patients (79.1%) had high risk disease. Seventy two patients (36.8%) had regional lymph node metastasis. Median SUVmax of primary tumor and metastatic lymph nodes were 13.0 (ranged 1.3 - 84.3) and 12.6 (ranged 3.6 – 64.5), respectively. Patients with GS 7 or lower had significantly lower SUVmax compared to patients with GS > 7 (12.1±8.4 vs. 20.9±16.4; p < 0.001). However, there was no significant difference in SUVmax of tumors with GS of 3+4 and 4+3 (14.8±8.6 vs. 16.3±12.7; p = 0.6). Patients with PSA ≥10.0 ng/mL exhibited significantly higher uptake than those with PSA levels < 10.0 ng/mL (12.1±8.4 vs. 20.9±16.4; p < 0.001). SUVmax of intermediate risk patients was significantly lower than that of high risk patients (12.7±11.1 vs. 19.8±16.8; p = 0.01). In 72 patients with lymph node metastasis SUVmax was significantly higher compared to 129 patients without lymph node metastasis (24.9±21.3 vs. 14.7±10.6; p < 0.001). Conclusions: Tumours with GS 7 or lower, patients with PSAvalues ≤10 ng/mL, intermediate risk patients and patients without regional lymph node metastasis showed significantly lower 68Ga-PSMA uptake. 68Ga-PSMA-PET/CT should be preferentially applied for primary staging of prostate cancer in patients with GS > 7, PSA levels ≥10 ng/ml, high risk patients and patients with regional lymph node metastasis.

Correlation of Lesional Uptake Parameters and Ratios with miPSMA Score and Estimating Normal Physiologic Concentration: An Exploratory Analysis in Metastatic Castration-Resistant Prostatic Carcinoma Patients with68Ga-PSMA-11 PET/CT

“…PSMA-based PET/CT imaging and theranostics have brought about a major change in the understanding and management of prostate cancer (9)(10)(11)(12)(13)(14)(15)(16)(17). The incorporation of semiquantitative and quantitative information continues to evolve and has the potential to enhance the fundamental understanding of tumor heterogeneity, in vivo kinetics, and response to various therapies and hence can be a valuable supplement to visual interpretation and of paramount importance for undertaking clinical research (9,10,13,17).…”

Molecular Imaging in Primary Staging of Prostate Cancer Patients: Current Aspects and Future Trends

“…Some studies investigated the impact of the intensity of [ 68 Ga]Ga-PSMA uptake in differentiation of the tumor. Correlations were shown between higher maximum standardized uptake value (SUV max ) with Gleason score >7 and higher PSA level [ 81 , 85 , 86 ], as well as the presence of distant metastasis [ 87 , 88 ].…”