Towards improved diagnosis: radiomics and quantitative biomarkers in 18 F-PSMA-1007 and 18 F-fluorocholine PET/CT for...

Area of Science:

• Nuclear medicine
• Oncology
• Radiochemistry

Background:

• Prostate cancer recurrence after definitive treatment is often detected by rising prostate-specific antigen (PSA) levels.
• Identifying the extent and location of metastatic disease in biochemical recurrence (BCR) is crucial for guiding treatment decisions.
• 18 F-fluorocholine (FCH) and 18 F-PSMA-1007 are positron emission tomography (PET) tracers used for imaging prostate cancer.

Purpose of the Study:

• To compare the radiomic features and quantitative biomarkers of 18 F-PSMA-1007 and FCH PET/CT.
• To evaluate the diagnostic performance of these tracers in identifying metastatic lesions in prostate cancer patients with BCR.

Main Methods:

• A prospective, multicenter study (BIO-CT-001) enrolled 106 patients with BCR.
• Patients underwent randomized 18 F-PSMA-1007 and FCH PET/CT within 10 days.
• Radiomic features (SUVmax, SUVmean, Total Lesion, Total Volume) and clinical data (PSA, PSA doubling time, PSA velocity) were analyzed.

Main Results:

• A total of 286 lesions were identified, including lymph node (49%), bone (41.2%), and locoregional recurrences (9.8%).
• 18 F-PSMA-1007 showed significantly higher median SUVmax, SUVmean, Total Lesion, and Total Volume compared to FCH (P < 0.001).
• Both tracers showed moderate correlations with PSA levels, but Total Lesion PSMA/FCH correlated better with PSA level and velocity.

Conclusions:

• 18 F-PSMA-1007 demonstrates superior performance compared to FCH in identifying metastatic lesions in prostate cancer patients with BCR.
• Quantitative biomarkers and radiomic features from 18 F-PSMA-1007 provide more sensitive detection of recurrent prostate cancer.