Skip to main content

Advertisement

SpringerLink
Log in

Modified PROMISE criteria for standardized interpretation of gastrin-releasing peptide receptor (GRPR)-targeted PET

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

There are image interpretation criteria to standardize reporting prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET). As up to 10% of prostate cancer (PC) do not express PSMA, other targets such as gastrin-releasing peptide receptor (GRPR) are evaluated. Research on GRPR-targeted imaging has been slowly increasing in usage at staging and biochemical recurrence (BCR) of PC. We therefore propose a modification of the Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria (mPROMISE) for GRPR-targeted PET.

Methods

[68 Ga]Ga-RM2 PET data from initially prospective studies performed at our institution were retrospectively reviewed: 44 patients were imaged for staging and 100 patients for BCR PC. Two nuclear medicine physicians independently evaluated PET according to the mPROMISE criteria. A third expert reader served as standard reference. Interreader reliability was computed for GRPR expression, prostate bed (T), lymph node (N), skeleton (Mb), organ (Mc) metastases, and final judgment of the scan.

Results

The interrater reliability for GRPR PET at staging was moderate for GRPR expression (0.59; 95% confidence interval [CI] 0.40, 0.78), substantial for T-stage (0.78; 95% CI 0.63, 0.94), and almost perfect for N-stage (0.97; 95% CI 0.92, 1.00) and final judgment (0.92; 95% CI 0.82, 1.00). The interreader agreement at BCR showed substantial agreement for GRPR expression (0.70; 95% CI 0.59, 0.81) and final judgment (0.65; 95% CI 0.53, 0.78), while almost perfect agreement was seen across the major categories (T, N, Mb, Mc). Acceptable performance of the mPROMISE criteria was found for all subsets when compared to the standard reference.

Conclusion

Interpreting GRPR-targeted PET using the mPROMISE criteria showed its reliability with substantial or almost perfect interrater agreement across all major categories. The proposed modification of the PROMISE criteria will aid clinicians in decreasing the level of uncertainty, and clinical trials to achieve uniform evaluation, reporting, and comparability of GRPR-targeted PET.

Trial registration

Clinicaltrials.gov Identifier: NCT03113617 and NCT02624518.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

Yes.

Code availability

Yes.

References

  1. Fanti S, Minozzi S, Morigi JJ, Giesel F, Ceci F, Uprimny C, et al. Development of standardized image interpretation for 68Ga-PSMA PET/CT to detect prostate cancer recurrent lesions. Eur J Nucl Med Mol Imaging. 2017;44:1622–35. https://doi.org/10.1007/s00259-017-3725-1.

    Article  CAS  PubMed  Google Scholar 

  2. Rowe SP, Pienta KJ, Pomper MG, Gorin MA. PSMA-RADS version 1.0: a step towards standardizing the interpretation and reporting of PSMA-targeted PET imaging studies. Eur Urol. 2018;73:485–7. https://doi.org/10.1016/j.eururo.2017.10.027.

    Article  PubMed  Google Scholar 

  3. Eiber M, Herrmann K, Calais J, Hadaschik B, Giesel FL, Hartenbach M, et al. Prostate cancer molecular imaging standardized evaluation (PROMISE): proposed miTNM classification for the interpretation of PSMA-ligand PET/CT. J Nucl Med. 2018;59:469–78. https://doi.org/10.2967/jnumed.117.198119.

    Article  PubMed  Google Scholar 

  4. Seifert R, Emmett L, Rowe SP, Herrmann K, Hadaschik B, Calais J, et al. Second version of the prostate cancer molecular imaging standardized evaluation framework including response evaluation for clinical trials (PROMISE V2). Eur Urol. 2023. https://doi.org/10.1016/j.eururo.2023.02.002.

    Article  PubMed  Google Scholar 

  5. Emmett L, Papa N, Buteau J, Ho B, Liu V, Roberts M, et al. The PRIMARY score: using intraprostatic (68)Ga-PSMA PET/CT patterns to optimize prostate cancer diagnosis. J Nucl Med. 2022;63:1644–50. https://doi.org/10.2967/jnumed.121.263448.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Maurer T, Gschwend JE, Rauscher I, Souvatzoglou M, Haller B, Weirich G, et al. Diagnostic efficacy of (68)gallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer. J Urol. 2016;195:1436–43. https://doi.org/10.1016/j.juro.2015.12.025.

    Article  PubMed  Google Scholar 

  7. Budaus L, Leyh-Bannurah SR, Salomon G, Michl U, Heinzer H, Huland H, et al. Initial experience of (68)Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy. Eur Urol. 2016;69:393–6. https://doi.org/10.1016/j.eururo.2015.06.010.

    Article  PubMed  Google Scholar 

  8. Duan H, Baratto L, Fan RE, Soerensen SJC, Liang T, Chung BI, et al. Correlation of (68)Ga-RM2 PET with postsurgery histopathology findings in patients with newly diagnosed intermediate- or high-risk prostate cancer. J Nucl Med. 2022;63:1829–35. https://doi.org/10.2967/jnumed.122.263971.

    Article  CAS  PubMed  Google Scholar 

  9. Baratto L, Song H, Duan H, Hatami N, Bagshaw H, Buyyounouski M, et al. PSMA- and GRPR-targeted PET: results from 50 patients with biochemically recurrent prostate cancer. J Nucl Med. 2021. https://doi.org/10.2967/jnumed.120.259630.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mapelli P, Ghezzo S, Samanes Gajate AM, Preza E, Palmisano A, Cucchiara V, et al. (68)Ga-PSMA and (68)Ga-DOTA-RM2 PET/MRI in recurrent prostate cancer: diagnostic performance and association with clinical and histopathological data. Cancers (Basel). 2022;14. https://doi.org/10.3390/cancers14020334.

  11. Minamimoto R, Sonni I, Hancock S, Vasanawala S, Loening A, Gambhir SS, et al. Prospective evaluation of (68)Ga-RM2 PET/MRI in patients with biochemical recurrence of prostate cancer and negative findings on conventional imaging. J Nucl Med. 2018;59:803–8. https://doi.org/10.2967/jnumed.117.197624.

    Article  CAS  PubMed  Google Scholar 

  12. Touijer KA, Michaud L, Alvarez HAV, Gopalan A, Kossatz S, Gonen M, et al. Prospective study of the radiolabeled GRPR antagonist BAY86-7548 for positron emission tomography/computed tomography imaging of newly diagnosed prostate cancer. Eur Urol Oncol. 2019;2:166–73. https://doi.org/10.1016/j.euo.2018.08.011.

    Article  PubMed  Google Scholar 

  13. Mapelli P, Ghezzo S, Samanes Gajate AM, Preza E, Brembilla G, Cucchiara V, et al. Preliminary results of an ongoing prospective clinical trial on the use of (68)Ga-PSMA and (68)Ga-DOTA-RM2 PET/MRI in staging of high-risk prostate cancer patients. Diagnostics (Basel). 2021;11. https://doi.org/10.3390/diagnostics11112068.

  14. Baratto L, Duan H, Laudicella R, Toriihara A, Hatami N, Ferri V, et al. Physiological (68)Ga-RM2 uptake in patients with biochemically recurrent prostate cancer: an atlas of semi-quantitative measurements. Eur J Nucl Med Mol Imaging. 2020;47:115–22. https://doi.org/10.1007/s00259-019-04503-4.

    Article  CAS  PubMed  Google Scholar 

  15. Cookson MS, Aus G, Burnett AL, Canby-Hagino ED, D’Amico AV, Dmochowski RR, et al. Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol. 2007;177:540–5. https://doi.org/10.1016/j.juro.2006.10.097.

    Article  CAS  PubMed  Google Scholar 

  16. Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65:965–74. https://doi.org/10.1016/j.ijrobp.2006.04.029.

    Article  PubMed  Google Scholar 

  17. Toriihara A, Nobashi T, Baratto L, Duan H, Moradi F, Park S, et al. Comparison of 3 interpretation criteria for (68)Ga-PSMA11 PET based on inter- and intrareader agreement. J Nucl Med. 2020;61:533–9. https://doi.org/10.2967/jnumed.119.232504.

    Article  CAS  PubMed  Google Scholar 

  18. Demirci E, Akyel R, Caner B, Alan-Selcuk N, Guven-Mese S, Ocak M, et al. Interobserver and intraobserver agreement on prostate-specific membrane antigen PET/CT images according to the miTNM and PSMA-RADS criteria. Nucl Med Commun. 2020;41:759–67. https://doi.org/10.1097/MNM.0000000000001219.

    Article  CAS  PubMed  Google Scholar 

  19. Duan H, Ghanouni P, Daniel B, Rosenberg J, Thong A, Kunder C, et al. A pilot study of (68)Ga-PSMA11 and (68)Ga-RM2 PET/MRI for biopsy guidance in patients with suspected prostate cancer. J Nucl Med. 2022. https://doi.org/10.2967/jnumed.122.264448.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Duan H, Ghanouni P, Daniel B, Rosenberg J, Davidzon GA, Mari Aparici C, et al. A pilot study of (68)Ga-PSMA11 and (68)Ga-RM2 PET/MRI for evaluation of prostate cancer response to high intensity focused ultrasound (HIFU) therapy. J Nucl Med. 2022. https://doi.org/10.2967/jnumed.122.264783.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Beer M, Montani M, Gerhardt J, Wild PJ, Hany TF, Hermanns T, et al. Profiling gastrin-releasing peptide receptor in prostate tissues: clinical implications and molecular correlates. Prostate. 2012;72:318–25. https://doi.org/10.1002/pros.21434.

    Article  CAS  PubMed  Google Scholar 

  22. Korner M, Waser B, Rehmann R, Reubi JC. Early over-expression of GRP receptors in prostatic carcinogenesis. Prostate. 2014;74:217–24. https://doi.org/10.1002/pros.22743.

    Article  CAS  PubMed  Google Scholar 

  23. Fendler WP, Calais J, Allen-Auerbach M, Bluemel C, Eberhardt N, Emmett L, et al. (68)Ga-PSMA-11 PET/CT interobserver agreement for prostate cancer assessments: an international multicenter prospective study. J Nucl Med. 2017;58:1617–23. https://doi.org/10.2967/jnumed.117.190827.

    Article  CAS  PubMed  Google Scholar 

  24. Nickols N, Anand A, Johnsson K, Brynolfsson J, Borreli P, Parikh N, et al. aPROMISE: a novel automated PROMISE platform to standardize evaluation of tumor burden in (18)F-DCFPyL images of veterans with prostate cancer. J Nucl Med. 2022;63:233–9. https://doi.org/10.2967/jnumed.120.261863.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA, 94305, USA

    Heying Duan, Guido A. Davidzon, Farshad Moradi, Tie Liang, Hong Song & Andrei Iagaru

Authors
  1. Heying Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guido A. Davidzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Farshad Moradi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tie Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hong Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrei Iagaru
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

HD: content planning, data analyses, manuscript writing, and editing; GAD: data analyses and manuscript editing; FM: data analyses and manuscript editing; TL: data analyses and manuscript editing; HS: manuscript editing; AI: content planning, data analyses, and manuscript editing.

Corresponding author

Correspondence to Andrei Iagaru.

Ethics declarations

Ethics approval

Yes.

Consent to participate

Yes.

Consent for publication

Yes.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Duan, H., Davidzon, G.A., Moradi, F. et al. Modified PROMISE criteria for standardized interpretation of gastrin-releasing peptide receptor (GRPR)-targeted PET. Eur J Nucl Med Mol Imaging 50, 4087–4095 (2023). https://doi.org/10.1007/s00259-023-06385-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-023-06385-z

Keywords

Search

Navigation