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Semi-automatic evaluation of baseline whole-body tumor burden as an imaging biomarker of 68Ga-PSMA-11 PET/CT in newly diagnosed prostate cancer

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Abstract

Objectives

The prognostic value of baseline tumor burden of prostate cancer was rarely studied. We aimed to evaluate the whole-body tumor burden of 68Ga- prostate specific membrane antigen-HBED-CC (68Ga-PSMA-11) PET/CT in newly diagnosed prostate cancer semi-automatically, and explore its preliminary application in predicting prognosis.

Methods

Similar to metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of 18F-FDG PET/CT, 68Ga-PSMA-11 PET/CT tumor burden parameters including whole-body PSMA tumor volume (wbPSMA-TV) and whole-body total lesions PSMA uptake (wbTL-PSMA) were acquired semi-automatically. The intra-observer and inter-observer reliability was analyzed. The relationship between tumor burden and prostate-specific antigen (PSA) value or Gleason score was investigated. The preliminary application of tumor burden in predicting progression-free survival (PFS) was explored.

Results

Fifty-nine newly diagnosed prostate cancer patients were retrospectively analyzed. Semi-automatic quantification of whole-body tumor burden had excellent intra-observer and inter-observer consistency [all intra-class correlation coefficient (ICC) > 0.990]. wbPSMA-TV and wbTL-PSMA were 32.6 (range 1.0–3968.2) cm3 and 161.9 (range 6.0–24971.7), respectively. wbPSMA-TV and wbTL-PSMA correlated with PSA (r = 0.858, p < 0.001; r = 0.879, p < 0.001) and Gleason score (r = 0.793, p < 0.001; r = 0.805, p < 0.001) significantly. In univariate analysis, wbPSMA-TV, wbTL-PSMA, SUVmax, SUVpeak, SUVmean, PSMA-TV, TL-PSMA of primary tumor, fPSA and Gleason score were independent significant predictors of PFS (all p < 0.05). Moreover, in multivariate analysis, wbTL-PSMA [hazard ratio (HR): 1.001, p = 0.014] and Gleason score (HR: 5.124, p = 0.031) can significantly predict progression-free prognosis.

Conclusions

As imaging biomarkers, wbPSMA-TV and wbTL-PSMA correlated with clinical characteristics significantly. High wbTL-PSMA or Gleason score was associated with shorter PFS of newly diagnosed prostate cancer independently.

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Funding

This work was supported by the National Natural Science Foundation of China (81871417, Ju Jiao); the Guangzhou Science and Technology Planning Project (201802020033, Yong Zhang); and the Guangdong Medical Research Foundation (A2018047, Qiong Zou).

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Author notes

  1. Qiong Zou and Ju Jiao contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, China

    Qiong Zou, Ju Jiao, Ting Yang, Lei Xu & Yong Zhang

  2. Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China

    Min-hong Zou

  3. Department of Urology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China

    Ming-zhao Li

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  1. Qiong Zou
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  2. Ju Jiao
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  4. Ming-zhao Li
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  7. Yong Zhang
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Correspondence to Yong Zhang.

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Zou, Q., Jiao, J., Zou, Mh. et al. Semi-automatic evaluation of baseline whole-body tumor burden as an imaging biomarker of 68Ga-PSMA-11 PET/CT in newly diagnosed prostate cancer. Abdom Radiol 45, 4202–4213 (2020). https://doi.org/10.1007/s00261-020-02745-7

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  • DOI: https://doi.org/10.1007/s00261-020-02745-7

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