|
Evaluation of 68Ga-PSMA PET/CT in the staging of patients with prostate cancer
|
M.M.M. Shehata   , H.A. Kader Morsy , R.S.E. Hussein , A.A.M. Okba |
| Department of Diagnostic Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt , mahmoud.shehata007@gmail.com |
|
|
Abstract: (603 Views) |
Background: Targeting prostate-specific membrane antigen (PSMA), with Gallium-68 PSMA-directed Positron Emission Tomography/Computed Tomography (68Ga-PSMA PET/CT) is advanced imaging technique for prostate cancer (PCa) diagnosis. The current study evaluated the performance of 68Ga-PSMA PET/CT for staging and follow-up of PCa patients. Material and Methods: 54 newly diagnosed (Group I) and 66 recurrent PCa patients (Group II) underwent estimation of serum total prostate-specific antigen (PSAT), calculation of PSA density (PSAD), and grading by the Gleason grading system. After obtaining the whole-body images using the integrated PET/CT scanner, Discovery IQ five-ring machine, and PET scanning, the maximum standardized uptake (SUV-max) values were calculated. Histopathology is the gold standard for assessment of the diagnostic performance of 68Ga-PSMA PET/CT for Group II. Results: The PSAT levels and density for Group I increased progressively with Gleason grade, with significant (P=0.021 and P=0.005, respectively) differences among grades. The lymph nodes and local tumor SUV-max were remarkably higher (P<0.001 & 0.01) in Group I. The SUV-max according to PSAT grades of Group I patients showed a significant (P<0.001) difference. There was positive, significant (P<0.001) relation between PSAD and SUV-max. The regression model for PSAD versus SUV-max was significant. The natural log of SUV-max increased by 2.03-fold with each fold increase in the natural log of PSAD. Conclusion: Integrating 68Ga-PSMA PET/CT in the diagnostic workup for PCa patients helps the management decision-making and is particularly valuable for lesions in areas inaccessible for biopsy, or if PSA levels are in the diagnostic gray-zone. |
|
| Keywords: Prostate cancer, prostate-specific membrane antigen, prostate-specific antigen density, 68Ga-PSMA PET/CT. |
|
|
Full-Text [PDF 1009 kb]
(236 Downloads)
|
|
Type of Study: Original Research |
Subject:
Radiation Biology
|
|
|
|
|
|
|
| References |
1. Xu Z, Chen X, He Y, Tong J, Chen C, Ding M, et al. (2025) The potential biological function of STARD8 in prostate cancer: A bioinformatic and experimental validation study. Biochim Biophys Acta Mol Basis Dis, 1871(6): 167897. [ DOI:10.1016/j.bbadis.2025.167897] 2. Crocetto F, Musone M, Chianese S, Conforti P, Selvaggio G, Caputo V, et al. (2025) Blood and urine-based biomarkers in prostate cancer: current advances, clinical applications, and future directions. J Liq Biopsy, 9: 100305. [ DOI:10.1016/j.jlb.2025.100305] 3. Nordström T, Akre O, Aly M, Grönberg H, Eklund M (2018) Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer. Prostate Cancer Prostatic Dis, 21(1): 57-63. [ DOI:10.1038/s41391-017-0024-7] 4. Pantelidou M, Caglic I, George A, Blyuss O, Gnanapragasam V, Barrett T (2022) Evaluation of transabdominal and transperineal ultrasound-derived prostate specific antigen (PSA) density and clinical utility compared to MRI prostate volumes: a feasibility study. PLoS One, 17(9): e0274014. [ DOI:10.1371/journal.pone.0274014] 5. Bostancı C and Demir DÖ (2024) The effect of the combination of prostate-specific antigen derivatives with multiparametric prostate magnetic resonance imaging scores on the negative predictive value of it in grey zone patients. Actas Urol Esp (Engl Ed), 48(3): 238-245. [ DOI:10.1016/j.acuroe.2023.10.004] 6. Wen J, Liu W, Shen X, Hu W (2024) PI-RADS v2.1 and PSAD for the prediction of clinically significant prostate cancer among patients with PSA levels of 4-10 ng/ml. Sci Rep, 14(1): 6570. [ DOI:10.1038/s41598-024-57337-y] 7. Diao W, Cai H, Chen L, Jin X, Liao X, Jia Z (2019) Recent advances in prostate-specific membrane antigen-based radiopharmaceuticals. Curr Top Med Chem, 19(1): 33-56. [ DOI:10.2174/1568026619666190201100739] 8. Wang L, Lu C, Wang X, Wu D (2025) PSMA-targeted therapy: from molecular mechanisms to clinical breakthroughs in castration-resistant prostate cancer. Eur J Med Chem, 296: 117829. [ DOI:10.1016/j.ejmech.2025.117829] 9. Pepe P, Pepe L, Cignoli D, Roscigno M (2025) PSMA PET/CT in the diagnosis of prostate cancer: why and when? Arch Ital Urol Androl, 97(2): 13746. [ DOI:10.4081/aiua.2025.13746] 10. Sogani PC, Israel A, Lieberman PH, Lesser ML, Whitmore WF Jr (1985) Gleason grading of prostate cancer: a predictor of survival. Urology, 25(3): 223-227. [ DOI:10.1016/0090-4295(85)90316-4] 11. Berger I, Annabattula C, Lewis J, Shetty DV, Kam J, Maclean F, et al. (2018) 68Ga-PSMA PET/CT vs. mpMRI for locoregional prostate cancer staging: correlation with final histopathology. Prostate Cancer Prostatic Dis, 21(2): 204-211. [ DOI:10.1038/s41391-018-0048-7] 12. Gurbuz Z, Unal U, Vuruskan E, Aydamirov M, Karkin K (2025) Factors influencing Gleason score up/downgrade in radical prostatectomy. BMC Urol, 25(1): 155. [ DOI:10.1186/s12894-025-01848-x] 13. Jin P, Wang X, Ding Z, Yang L, Xu C, Wang X, Huang F (2025) Development and validation of risk-stratified biopsy decision pathways incorporating MRI and PSA-derived indicators. Ann Med, 57(1): 2446695. [ DOI:10.1080/07853890.2024.2446695] 14. Quarta L, Stabile A, Pellegrino F, Scilipoti P, Longoni M, Cannoletta D, et al. (2025) Tailored use of PSA density according to multiparametric MRI index lesion location: results of a large, multi-institutional series. Prostate Cancer Prostatic Dis, [Epub ahead of print]. [ DOI:10.1038/s41391-025-00987-4] 15. Heetman J, Pereira L, Kelder J, Soeterik T, Wever L, Lavalaye J, et al. (2024) The additional value of 68Ga-PSMA PET/CT SUVmax in predicting ISUP GG ≥2 and ISUP GG ≥3 prostate cancer in biopsy. Prostate, 84(11): 1025-1032. [ DOI:10.1002/pros.24716] 16. Pepe P, Pepe L, Pennisi M (2024) Negative biopsy histology in men with PI-RADS score 5: is it useful PSMA PET/CT evaluation? Arch Ital Urol Androl, 96(2): 12358. [ DOI:10.4081/aiua.2024.12358] 17. Chen M, Guo S, Wang J, Wang N, Wen S, Zhang H, et al. (2025) Development and validation of multivariable biopsy-free nomograms to predict clinically significant prostate cancer in patients with prostate-specific antigen levels ≥20 ng/mL. Transl Androl Urol, 14(3): 507-518. [ DOI:10.21037/tau-24-533] 18. Li Y, Li J, Yang J, Xiao L, Zhou M, Cai Y, et al. (2025) Using a novel PSMA-PET and PSA-based model to enhance the diagnostic accuracy for clinically significant prostate cancer and avoid unnecessary biopsy in men with PI-RADS ≤3 MRI. Eur J Nucl Med Mol Imaging, 52(3): 913-924. [ DOI:10.1007/s00259-025-07089-2] 19. Wang J, Chen M, Guo S, Xu Y, Liu L, Jiang X (2025) Development and validation of biopsy-free nomograms for predicting clinically significant prostate cancer in men with PI-RADS 4 and 5 lesions. Sci Rep, 15(1): 2506. [ DOI:10.1038/s41598-025-86607-6] 20. Falkenbach F, Schmalhofer M, Tian Z, Mazzucato G, Karakiewicz P, Graefen M, et al. (2025) Size and SUVmax define the contribution of nodal metastases to PSA in oligorecurrent prostate cancer. Prostate, 85(1): 105-111. [ DOI:10.1002/pros.24806] 21. Li R, Fu Y, Peng S, Yang F, Ai S, Wang F, et al. (2025) Pathological and radiological features of false-positive lesions on [68Ga]Ga-PSMA-11 PET/CT in primary staging of prostate cancer: a radio-pathology matching analysis. Eur J Nucl Med Mol Imaging, 52(8): 2804-2813. [ DOI:10.1007/s00259-025-07148-8] |
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
Shehata M, Kader Morsy H, Hussein R, Okba A. Evaluation of 68Ga-PSMA PET/CT in the staging of patients with prostate cancer. Int J Radiat Res 2026; 24 (2) :397-403 URL: http://ijrr.com/article-1-7018-en.html
|
