Standardised uptake values as determined on prostate‐specific membrane antigen positron emission tomography/computed tomography is associated with oncological outcomes in patients with prostate cancer

• Published in: BJU international 2022-06, Vol.129 (6), p.768-776
• Main Authors: Bodar, Yves J.L., Veerman, Hans, Meijer, Dennie, de Bie, Katelijne, van Leeuwen, Pim J., Donswijk, Maarten L., van Moorselaar, R. Jeroen A., Hendrikse, N. Harry, Boellaard, Ronald, Oprea‐Lager, Daniela E., Vis, André N.
• Format: Article
• Language: English
• Subjects: 18F‐DCFPyL; 68Ga‐PSMA‐11; Antigens; biomarkers; Biopsy; Computed tomography; Lymph nodes; Original; Pathology; Patients; PCSM; Positron emission tomography; Prostate cancer; ProstateCancer; Prostatectomy; Radioactive tracers; standardised uptake values; Tomography; Tumors; uroonc
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.15710

Objectives To investigate the association between intraprostatic, intratumoral maximum standardised uptake values (SUVmax) on prostate‐specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer (PCa) prior to robot‐assisted radical prostatectomy (RARP) and pathology outcomes, including pathological International Society of Urological Pathology score (pISUP) and lymph node (LN) status (pN0/pN1). Patients and Methods A bi‐centric, secondary analysis of two previous, prospective cohort studies was performed in 318 patients with biopsy confirmed PCa and who were scheduled for RARP. Before surgery, patients received a PSMA PET/CT with either 68Ga‐PSMA‐11 (59% of the patients) or 18F‐PSMA (DCFPyL; 41%) as radiotracer. PET/CT images were analysed both visually and semi‐quantitatively by measuring the SUVmax of the most intense suspect lesion in the prostate. The association between the SUVmax of the primary tumour and pre‐ and postoperative variables was analysed. Results The SUVmax was associated with clinical and biopsy preoperative variables, as well as with pISUP score and pathological tumour stage. Patients with a pISUP of ≤2 showed significantly lower SUVmax compared to patients with a pISUP of >2 for both tracers (SUVmax 18F‐PSMA: median 5.1 vs 9.6, P = 0.002; SUVmax 68Ga‐PSMA‐11: 6.6 vs 8.6, P = 0.003). Moreover, patients with pN1 had significantly higher median SUVmax than those with pN0/pNx for both tracers (SUVmax 18F‐PSMA: 7.9 vs 12.3, P = 0.04; SUVmax 68Ga‐PSMA‐11: 7.6 vs 12.0, P