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The role of histopathological and biochemical parameters for predicting metastatic disease on Ga-68-PSMA-11 PET in prostate cancer

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Date

2021

Author

Aydos, Uğuray
Çetin, Serhat
Akdemir, Ümit Özgür
Budak, Fırat Çağlar
Ateş, Seda Gülbahar
Koparal, Murat Yavuz
Gönül, İpek Işık
Gülbahar, Özlem
Sözen Sinan
Atay, Lütfiye Özlem

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Aydos, U., Çetin, S., Akdemir, Ü. Ö., Budak, F. Ç., Ateş, S. G., Koparal, M. Y., Gönül, İ. I., Gülbahar, Ö., Sözen, S., & Atay, L. Ö. (2021). The role of histopathological and biochemical parameters for predicting metastatic disease on 68 Ga-PSMA-11 PET in prostate cancer. The Prostate, 81(16), 1337–1348. https://doi.org/10.1002/pros.24231

Abstract

Background The aim of this study was to evaluate the role of histopathological and biochemical parameters in the prediction of the presence and number of PSMA positive lesions consistent with the metastatic spread of prostate cancer on Ga-68-PSMA PET images. Methods Biochemical, histopathological and imaging data of 302 prostate cancer patients who underwent Ga-68-PSMA-11 PET/CT or PET/MR imaging for primary staging were retrospectively analyzed. Patients were divided into two groups as "PET positive" and "PET negative" according to the presence of pathologic extraprostatic PSMA involvement. "PET positive" patients were additionally divided into two groups: oligometastatic (1-3 metastatic lesion) and multimetastatic (>3 metastatic lesions). Results The mean age of patients was 66.8 +/- 7.6 years. Imaging modality was PET/MR in 223 (73.8%) and PET/CT in 79 (26.2%) of patients. Total PSA, PSA density (PSAD), ALP, and tumor ratio in biopsy specimens were found to be significantly higher in "PET positive" group compared to "PET negative" group and in multimetastatic group compared to oligometastatic group. PET positivity was observed in 3.8% of the low-intermediate risk groups (ISUP 1-3 and total PSA <= 20 ng/ml and PSAD < 0.15 ng/ml/cc). This ratio was 46% in the high-risk group (ISUP 4-5 or total PSA > 20 ng/ml or PSAD >= 0.15 ng/ml/cc) with a relative risk of 12 (p < .001). The prediction models to predict the PET positivity and the presence of distant metastasis had AUCs of 0.901 and 0.925, respectively; with ALP, total PSA, and tumor ratio in needle biopsy specimen as significant independent predictors (p < .05). Conclusions In this study, Ga-68-PSMA-11 PET positivity was significantly higher in the high-risk patient group than in the low-intermediate risk groups. The prediction models used for predicting the PET positivity and the presence of distant metastasis on PET imaging were successful with high discriminatory powers. In addition to total PSA and ISUP GG, ALP and tumor ratio in biopsy specimens can be used to identify high-risk patients.

Source

The Prostate

Volume

81

Issue

16

URI

https://doi.org/10.1002/pros.24231
https://hdl.handle.net/11436/6735

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  • PubMed İndeksli Yayınlar Koleksiyonu [2443]
  • Scopus İndeksli Yayınlar Koleksiyonu [6032]
  • TF, Cerrahi Tıp Bilimleri Bölümü Koleksiyonu [1225]
  • WoS İndeksli Yayınlar Koleksiyonu [5260]



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