The additional value of 68 Ga-PSMA PET/CT SUVmax in predicting ISUP GG ≥ 2 and ISUP GG ≥ 3 prostate cancer in biopsy.

Autor: Heetman JG; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Paulino Pereira LJ; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Kelder JC; Department of Cardiology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Soeterik TFW; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Wever L; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Lavalaye J; Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., van der Hoeven EJRJ; Department of Radiology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., Lam MGEH; Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands., van Melick HHE; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands., van den Bergh RCN; Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands.
Jazyk: angličtina
Zdroj: The Prostate [Prostate] 2024 Aug; Vol. 84 (11), pp. 1025-1032. Date of Electronic Publication: 2024 May 05.
DOI: 10.1002/pros.24716
Abstrakt: Background: Prebiopsy magnetic resonance imaging (MRI) increases the detection rate of clinically significant prostate cancer (csPCa). Prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA PET/CT) maximum standardized uptake value (SUVmax) of the prostate may offer additional value in predicting the likelihood of csPCa in biopsy.
Methods: A single-center cohort study involving patients with biopsy-proven PCa who underwent both MRI and PSMA PET/CT between 2020 and 2021. Logistic regression models were developed for International Society of Urological Pathology (ISUP) Grade Group (GG) ≥ 2 and GG ≥ 3 using noninvasive prebiopsy parameters: age, (log-)prostate-specific antigen (PSA) density, PI-RADS 5 lesion presence, extraprostatic extension (EPE) on MRI, and SUVmax of the prostate. Models with and without SUVmax were compared using Likelihood ratio tests and area under the curve (AUC). DeLong's test was used to compare the AUCs.
Results: The study included 386 patients, with 262 (68%) having ISUP GG ≥ 2 and 180 (47%) having ISUP GG ≥ 3. Including SUVmax significantly improved both models' goodness of fit (p < 0.001). The GG ≥ 2 model had a higher AUC with SUVmax 89.16% (95% confidence interval [CI]: 86.06%-92.26%) than without 87.34% (95% CI: 83.93%-90.76%) (p = 0.026). Similarly, the GG ≥ 3 model had a higher AUC with SUVmax 82.51% (95% CI: 78.41%-86.6%) than without 79.33% (95% CI: 74.84%-83.83%) (p = 0.003). The SUVmax inclusion improved the GG ≥ 3 model's calibration at higher probabilities.
Conclusion: SUVmax of the prostate on PSMA PET/CT potentially improves diagnostic accuracy in predicting the likelihood of csPCa in prostate biopsy.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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