Quantitative PSMA-PET parameters in localized prostate cancer: prognostic and potential predictive value

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Prostate cancer (PCA) staging increasingly utilizes Prostate-Specific Membrane Antigen Positron Emission Tomography (PSMA-PET).
• The prognostic significance of quantitative PSMA-PET parameters for localized PCA remains unclear.

Purpose of the Study:

• To evaluate the prognostic value of quantitative PSMA-PET parameters in localized prostate cancer.
• To determine if imaging parameters impact disease progression and survival outcomes.

Main Methods:

• Retrospective analysis of 86 localized PCA patients undergoing PSMA-PET before treatment.
• Assessed quantitative PET parameters: SUVmax, asphericity (ASP), PSMA tumor volume (PSMA-TV), and PSMA total lesion uptake (PSMA-TLU).
• Utilized Cox regression for biochemical recurrence-free survival, overall survival (OS), local control, and loco-regional control (LRC).

Main Results:

• PSMA-TV, PSMA-TLU, and ASP significantly correlated with OS in the overall cohort.
• Binarized PET parameters showed associations with clinical outcomes.
• SUVmax cutoff (8.6) associated with LRC in surgically treated high-risk PCA, but not in irradiated patients.
• PSMA-TLU showed promise for stratifying surgical patients (p=0.016).

Conclusions:

• Confirms SUVmax prognostic impact in surgically treated high-risk PCA.
• Suggests PSMA-TLU as a potentially superior biomarker for surgical patients.
• Highlights the need for prospective validation of PSMA-PET parameters in irradiated PCA patients.