Semi-automatic evaluation of baseline whole-body tumor burden as an imaging biomarker of 68Ga-PSMA-11 PET/CT in newly diagnosed prostate cancer.

Abstract

OBJECTIVES:

The prognostic value of baseline tumor burden of prostate cancer was rarely studied. We aimed to evaluate the whole-body tumor burden of 68Ga- prostate specific membrane antigen-HBED-CC (68Ga-PSMA-11) PET/CT in newly diagnosed prostate cancer semi-automatically, and explore its preliminary application in predicting prognosis.

METHODS:

Similar to metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of 18F-FDG PET/CT, 68Ga-PSMA-11 PET/CT tumor burden parameters including whole-body PSMA tumor volume (wbPSMA-TV) and whole-body total lesions PSMA uptake (wbTL-PSMA) were acquired semi-automatically. The intra-observer and inter-observer reliability was analyzed. The relationship between tumor burden and prostate-specific antigen (PSA) value or Gleason score was investigated. The preliminary application of tumor burden in predicting progression-free survival (PFS) was explored.

RESULTS:

Fifty-nine newly diagnosed prostate cancer patients were retrospectively analyzed. Semi-automatic quantification of whole-body tumor burden had excellent intra-observer and inter-observer consistency [all intra-class correlation coefficient (ICC) > 0.990]. wbPSMA-TV and wbTL-PSMA were 32.6 (range 1.0-3968.2) cm3 and 161.9 (range 6.0-24971.7), respectively. wbPSMA-TV and wbTL-PSMA correlated with PSA (r = 0.858, p < 0.001; r = 0.879, p < 0.001) and Gleason score (r = 0.793, p < 0.001; r = 0.805, p < 0.001) significantly. In univariate analysis, wbPSMA-TV, wbTL-PSMA, SUVmax, SUVpeak, SUVmean, PSMA-TV, TL-PSMA of primary tumor, fPSA and Gleason score were independent significant predictors of PFS (all p < 0.05). Moreover, in multivariate analysis, wbTL-PSMA [hazard ratio (HR): 1.001, p = 0.014] and Gleason score (HR: 5.124, p = 0.031) can significantly predict progression-free prognosis.

CONCLUSIONS:

As imaging biomarkers, wbPSMA-TV and wbTL-PSMA correlated with clinical characteristics significantly. High wbTL-PSMA or Gleason score was associated with shorter PFS of newly diagnosed prostate cancer independently.

• Authors: Qiong Zou, Ju Jiao, Min-Hong Zou, Ming-Zhao Li, Ting Yang, Lei Xu, Yong Zhang
• Journal: Abdominal radiology (New York) (Abdom Radiol (NY)) Vol. 45 Issue 12 Pg. 4202-4213 (12 2020) ISSN: 2366-0058 [Electronic] United States
• PMID: 32948911 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Gallium Isotopes
• Gallium Radioisotopes
• Oligopeptides
• gallium 68 PSMA-11
• Edetic Acid

Topics

• Biomarkers
• Edetic Acid (analogs & derivatives)
• Gallium Isotopes
• Gallium Radioisotopes
• Humans
• Male
• Oligopeptides
• Positron Emission Tomography Computed Tomography
• Prostatic Neoplasms (diagnostic imaging)
• Reproducibility of Results
• Retrospective Studies
• Tumor Burden