Department of Diagnostic Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt , mahmoud.shehata007@gmail.com
Abstract: (17 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.