Primary Tumor Heterogeneity on Pre-treatment [68Ga]Ga-PSMA PET/CT for the Prediction of Biochemical Recurrence in Prostate Cancer Heterogeneidad del tumor primario en la PET/TC con [68Ga]Ga-PSMA previa al tratamiento para la predicción de la recurrencia bioquímica en el cáncer de próstata


GÜLBAHAR ATEŞ S., DEMİREL B. B., Kekilli E., ÖZTÜRK E., UÇMAK G.

Revista Espanola de Medicina Nuclear e Imagen Molecular, cilt.43, sa.6, 2024 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 6
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1016/j.remn.2024.500032
  • Dergi Adı: Revista Espanola de Medicina Nuclear e Imagen Molecular
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: [68Ga]Ga-PSMA PET, Prostate cancer, Radiomics, Texture analysis, Tumor heterogeneity
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Purpose: The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies. Methods: Fifty-one patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses. Results: Twenty-nine (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P=.050), GLCM-sum variance (P=.019), and GLCM-cluster prominence (P=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P=.009) and GLCM-sum variance (P=.004) were found as independent predictors of BCR in the multivariate analysis. Conclusion: Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.