Correlation between Prostate Cancer Positive Cores and 68Ga-PSMA Distribution in Prostate Gland

Area of Science:

• Nuclear Medicine Imaging
• Oncology
• Radiochemistry

Background:

• Prostate cancer (PCa) diagnosis relies on imaging and biopsy, but challenges remain in identifying clinically significant disease.
• 68Ga-labeled prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) offers a promising imaging modality.

Purpose of the Study:

• To evaluate the reliability of 68Ga-PSMA PET/CT for prostate cancer diagnosis.
• To establish appropriate SUVmax cutoff values for differentiating PCa and clinically significant PCa (csPCa).

Main Methods:

• Retrospective analysis of 84 patients who underwent 68Ga-PSMA PET/CT after transrectal ultrasound-guided prostate biopsy (TRUS-bx).
• Manual segmentation of prostate diagrams into 6 regions per patient, with analysis of SUVmax values correlated to Gleason scores from histopathology.
• Receiver operating characteristic (ROC) curve analysis to determine SUVmax cutoff values.

Main Results:

• Mean SUVmax was significantly lower in Gleason grade group 1 (GG1) compared to higher grades (p < 0.001).
• SUVmax cutoff of 1.0 demonstrated high accuracy for tumor detection (99.4% sensitivity, 92.1% specificity).
• SUVmax cutoff of 4.2 was identified for detecting clinically significant PCa (88.8% sensitivity, 62.4% specificity).

Conclusions:

• 68Ga-PSMA PET/CT is a reliable tool for prostate cancer diagnosis and management.
• This imaging technique is particularly useful for discriminating clinically significant PCa and in patients with persistent suspicion for the disease.