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Diagnostic value of 18F-FDG PET/CT in patients with biochemical recurrent prostate cancer and negative 68Ga-PSMA PET/CT

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

Abstract

Purpose

68Ga-PSMA PET/CT has a high detection rate in prostate cancer patients with biochemical recurrence (BCR). However, few studies have reported other imaging methods for BCR with negative 68Ga-PSMA PET/CT findings. We investigated the value of 18F-FDG compared with 68Ga-PSMA and identified BCR patients with 68Ga-PSMA-negative findings who are most likely to benefit from 18F-FDG PET/CT.

Methods

Seventy-two BCR patients with negative 68Ga-PSMA PET/CT findings were retrospectively identified from 510 patients who underwent concomitant 68Ga-PSMA and 18F-FDG PET/CT between June 2018 and August 2020. Patients were categorised into groups with positive or negative 18F-FDG PET/CT findings. Differences in patients’ characteristics between these two groups and predictors of positive 18F-FDG findings were analysed.

Results

The detection rate of 18F-FDG PET/CT was 16.7% (12/72) in BCR patients with 68Ga-PSMA-negative findings. PSA and Gleason score were significantly higher in the 18F-FDG-positive group than in the 18F-FDG-negative group (P < 0.001 and P < 0.001, respectively). A multivariate analysis indicated that PSA (PSA ≥2.3 ng/mL) and Gleason score (Gleason score ≥ 8) correlated with 18F-FDG-positive findings (P < 0.001 and P = 0.015, respectively). The probabilities of 18F-FDG-positive findings in the low-potential (PSA <2.3 ng/mL and Gleason score <8), moderate-potential (PSA <2.3 ng/mL and Gleason score ≥ 8 or PSA ≥2.3 ng/mL and Gleason score <8), and high-potential (PSA ≥2.3 ng/mL and Gleason score ≥ 8) groups were 0%, 11.5%, and 90.0%, respectively (P < 0.001).

Conclusion

PSA level and Gleason score are independent predictors of 18F-FDG-positive findings, and BCR patients with 68Ga-PSMA-negative findings with high PSA and Gleason score are most likely to benefit from 18F-FDG PET/CT.

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Data availability

The data in this study can obtain from the corresponding author upon request.

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Funding

The study was supported by the National Natural Science Foundation of China (no. 81701724).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Ruohua Chen, Yining Wang, Yiping Shi, Lian Xu, Gang Huang & Jianjun Liu

  2. Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Yinjie Zhu

  3. Shanghai University of Medicine & Health Sciences, Shanghai, China

    Gang Huang

Authors
  1. Ruohua Chen
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  2. Yining Wang
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  3. Yiping Shi
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  4. Yinjie Zhu
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  5. Lian Xu
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  6. Gang Huang
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  7. Jianjun Liu
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Contributions

Ruohua Chen, Jianjun Liu, and Gang Huang designed and wrote the experiments. Ruohua Chen, Yining Wang, Yiping Shi, and Lian Xu collected and analysed the data. Yinjie Zhu revised the manuscript.

Corresponding authors

Correspondence to Gang Huang or Jianjun Liu.

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The study involving human participants was in line with the principles of the ethics committee of Renji Hospital and the Declaration of Helsinki in 1964. This study does not include animal research. Informed consent was not obtained.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Oncology - Genitourinary

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Chen, R., Wang, Y., Shi, Y. et al. Diagnostic value of 18F-FDG PET/CT in patients with biochemical recurrent prostate cancer and negative 68Ga-PSMA PET/CT. Eur J Nucl Med Mol Imaging 48, 2970–2977 (2021). https://doi.org/10.1007/s00259-021-05221-6

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  • DOI: https://doi.org/10.1007/s00259-021-05221-6

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