Can the Gleason score be predicted in patients with prostate cancer? A dynamic contrast-enhanced MRI,(68)Ga-PSMA PET/CT, PSA, and PSA-density comparison study
Diagnostic and Interventional Radiology, cilt.29, sa.5, ss.647-655, 2023 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 5
- Basım Tarihi: 2023
- Doi Numarası: 10.4274/dir.2023.232186
- Dergi Adı: Diagnostic and Interventional Radiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.647-655
- Anahtar Kelimeler: Ga-(68)-PSMA PET/CT, prostate perfusion MRI, wash-out rate, wash-in rate, PSA, PSA density
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
PURPOSE The present study aims to evaluate whether perfusion parameters in prostate magnetic resonance imaging (MRI),(68)Gaprostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT), prostate-specific antigen (PSA), and PSA density can be used to predict the lesion grade in patients with prostate cancer (PCa). METHODS The study included a total of 137 PCa cases in which 12-quadrant transrectal ultrasound-guided prostate biopsy (TRUSBx) was performed, the Gleason score (GS) was determined, and pre-biopsy multiparametric prostate MRI and(68)Ga-PSMA PET/CT examinations were undertaken. The patient population was evaluated in three groups according to the GS: (1) low risk; (2) intermediate risk; (3) high risk. The PSA, PSA density, pre-TRUSBx(68)Ga-PSMA PET/CT maximum standardized uptake value (SUVmax), perfusion MRI parameters [maximum enhancement, maximum relative enhancement, T0 (s), time to peak (s), wash-in rate (s-1), and wash-out rate (s-1)] were retrospectively evaluated. RESULTS There was no significant difference between the three groups in relation to the PSA, PSA density, and(68)Ga-PSMA PET/CT SUVmax (P > 0.05). However, the values of maximum enhancement, maximum relative enhancement (%), T0 (s), time to peak (s), wash-in rate (s-1), and wash-out rate (s-1) significantly differed among the groups. A moderate positive correlation was found among the prostate volume, PSA (r = 0.490), and(68)Ga-PSMA SUVmax (r = 0.322) in the patients. The wash-out rate (s-1) and wash-in rate (s-1) had the best diagnostic test performance (area under the curve: 89.1% and 78.4%, respectively). CONCLUSION No significant correlation was found between the(68)Ga-PSMA PET/CT SUVmax and the GS. The wash-out rate was more successful in estimating the pretreatment GS than the(68)Ga-PSMA PET/CT SUVmax.