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A single-center, multi-factor, retrospective study to improve the diagnostic accuracy of primary prostate cancer using [68Ga]Ga-PSMA-11 total-body PET/CT imaging

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To improve the diagnostic accuracy of initial detection in patients with suspected primary prostate cancer (PCa).

Methods

Eighty-four patients who underwent Gallium-68–labeled prostate-specific membrane antigen ([68Ga]Ga-PSMA-11) total-body positron emission tomography/computed tomography (PET/CT) imaging before treatment in our department were enrolled. The maximum standard uptake value (SUVmax) of the prostate (SUVmax-PSMA), liver (SUVmax-PSMA-L), and mediastinal blood pool (SUVmax-PSMA-M) was measured using [68Ga]Ga-PSMA-11 total-body PET/CT imaging. The [68Ga]Ga-PSMA-11 derived metabolic tumor volume (MTV), the total lesion (TLP), and the cross-sectional areas of focal concentration in the prostate (CAP) were also determined. Besides, the prostate-specific antigen (PSA) levels and the above imaging characteristics were analyzed using receiver operating characteristic curves to identify the cutoff value to improve the diagnostic accuracy of suspected PCa. Finally, a multivariate regression analysis was conducted to discover the independent predictor to improve the diagnostic accuracy on [68Ga]Ga-PSMA-11 total-body imaging.

Results

There was no significant difference between the PCa and Non-PCa groups in age, height, weight, injected dose, except for the PSA levels, the SUVmax-PSMA, TLP, MTV, and CAP. Besides, the SUVmax-PSMA-T/L and SUVmax-PSMA-T/M derived from SUVmax-PSMA were both significantly different. In addition, the areas under the curve of PSA levels, SUVmax-PSMA, SUVmax-PSMA-T/L, SUVmax-PSMA-T/M, TLP, MTV, and CAP to predict PCa on [68Ga]Ga-PSMA-11 imaging were 0.620 (95% confidence interval (CI) 0.485–0.755), 0.864 (95% CI 0.757–0.972), 0.819 (95% CI 0.704–0.935), 0.876 (95% CI 0.771–0.980), 0.845 (95% CI 0.741–0.949), 0.820 (95% CI 0.702–0.938), 0.627 (95% CI 0.499–0.754), respectively. However, a multivariate regression analysis showed that SUVmax-PSMA was an independent predictor, with a cutoff value of 11.5 and an odds ratio of 1.221.

Conclusion

The SUVmax-PSMA with a cutoff value of 11.5 was an independent predictor to improve the diagnostic accuracy of PCa on [68Ga]Ga-PSMA-11 total-body imaging.

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Data availability

The dataset used and/or analyzed in the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

This study was funded by the Shanghai Municipal Key Clinical Specialty Project (grant number: SHSLCZDZK03401), the Major Science and Technology Projects for Major New Drug Creation (grant number: 2019ZX09302001), the Shanghai Science and Technology Committee program (grant number: 20DZ2201800), the Three-year Action Plan of Clinical Skills and Innovation of Shanghai Hospital Development Center (grant number: SHDC2020CR3079B), and the Shanghai Sailing Program (19YF1408200).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Jing Lv, Haojun Yu, Hongyan Yin, Yimeng Shi & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China

    Jing Lv, Haojun Yu, Hongyan Yin, Yimeng Shi & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Jing Lv, Haojun Yu, Hongyan Yin, Yimeng Shi & Hongcheng Shi

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  1. Jing Lv
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Contributions

JL and HS were responsible for the design of the study. JL, HY, and HY were involved in data acquisition. JL, HY, and YS participated in data analysis. JL and HS drafted the manuscript and improved the performance of the research.

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Correspondence to Hongcheng Shi.

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This study was approved by the institutional review board of Zhongshan Hospital, Fudan University (IRB number: B2020-266R). Written informed consent was obtained from all participants.

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Lv, J., Yu, H., Yin, H. et al. A single-center, multi-factor, retrospective study to improve the diagnostic accuracy of primary prostate cancer using [68Ga]Ga-PSMA-11 total-body PET/CT imaging. Eur J Nucl Med Mol Imaging 51, 919–927 (2024). https://doi.org/10.1007/s00259-023-06464-1

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  • DOI: https://doi.org/10.1007/s00259-023-06464-1

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