The prognostic role of staging [18F]PSMA-1007 PET/CT volumetric and dissemination features in prostate cancer
摘要
This study aimed the role of volumetric and dissemination features of staging [18F]PSMA-1007 PET/CT in predicting progression‐free survival (PFS) in patients with prostate cancer (PCa) and their relationship with the main clinical data (ISUP grade groups, number of lesions, PSA).
MethodsWe included 164 patients with high-risk PCa who underwent baseline [18F]PSMA-1007 PET/CT. With the help of LIFEx version 7.7, the main volumetric and dissemination PET parameters were semi-automatically extracted: PSMA-prostate tumor volume (PSMA-TV), PSMA-prostate total lesion (PSMA-TL), PSMA total TV (PSMA-TTV), PSMA total TL (PSMA-TTL) and Dmax corrected for body-surface-area (Dmaxbsa). Spearman rank correlations between semiquantitative PET features and the clinical variables were analyzed. PFS estimates were plotted with the Kaplan–Meier method.
ResultsA high correlation was seen between the number of lesions and both PSMA-TTL (r 0.725), and Dmaxbsa (r 0.935). A moderate correlation was registered between PSA and PSMA-TTV (r 0.333), PSMA-TTL (r 0.441), Dmaxbsa (r 0.333), as well as between number of lesions and PSMA-TTV (r 0.342).
After a median follow-up of 17 months (range 2–45), relapse/progression happened in 17 patients (10%). PSA level, presence of distant metastases at staging, PSMA-TV, PSMA-TL, PSMA-TTL and Dmaxbsa were significantly associated with PFS at univariate analysis, but only the presence of distant metastases, PSMA-TTL and Dmaxbsa were confirmed to be independent prognostic factors.
ConclusionVolumetric and dissemination features derived by staging [18F]PSMA-1007 PET/CT were significantly correlated with PSA and number of lesions. The combination of PSMA-TTL and Dmaxbsa was the best predictor of PFS and may help to better stratify PCa patients.