Ga-68-PSMA PET/CT in treatment-naïve patients with prostate cancer: Which clinical parameters and risk stratification systems best predict PSMA-positive metastases?
Rogasch JM, Cash H, Zschaeck S, Elezkurtaj S, Brenner W, Hamm B, Makowski M, Amthauer H, Furth C, Baur ADJ (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 78
Pages Range: 1103-1110
Journal Issue: 14
DOI: 10.1002/pros.23685
Abstract
Purpose: To evaluate the accuracy of clinical parameters and established pre-treatment risk stratification systems for prostate cancer (PCa) in predicting PSMA-positive metastases in men undergoing Ga-68-PSMA PET/CT as initial staging examination. Materials and Methods: A retrospective analysis in 108 consecutive treatment-naïve patients with biopsy-proven PCa undergoing Ga-68-PSMA PET/CT (median age, 72 years [range, 49-82 years]) was performed. Prediction of PSMA-positive metastases by serum PSA, clinical T stage (cT), ISUP group, percentage of positive biopsy cores, and derived risk scores (D'Amico risk classification system, Roach [RF], Yale formula [YF], and Briganti nomogram [BN]) was examined with ROC analysis. Results: Any PSMA-positive metastases were found in 36 of 108 patients, including LN metastases in 28 patients, extrapelvic LN metastases in 15 patients, and organ metastases in 19 patients (bone, 19; lung, 1). AUCs for PSA, cT, ISUP, and percentage of positive biopsy cores regarding PSMA-positive metastases did not differ significantly (range, 0.6-0.8; each P > 0.05). D'Amico (AUC, 0.61-0.64) was inferior to RF (0.76-0.83), YF (0.81-0.86), and BN (0.73 to 0.88; each P < 0.05). Among the 89 high-risk patients (D'Amico), decision for or against PET imaging based on RF (cut-off, >18.0), YF (>10.8), or BN (>8.0) would have prevented PSMA PET/CT in 4 (5%), 15 (17%), or 18 patients (20%), respectively, while preserving a sensitivity ≥95% for PSMA-positive metastases. Conclusions: Clinical parameters and established risk stratification systems for PCa can predict Ga-68-PSMA PET-positive metastases in treatment-naïve patients. Especially YF and BN may improve identification of patients with the highest probability of metastatic disease detected by Ga-68-PSMA PET/CT.
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Germany (DE)How to cite
APA:
Rogasch, J.M., Cash, H., Zschaeck, S., Elezkurtaj, S., Brenner, W., Hamm, B.,... Baur, A.D.J. (2018). Ga-68-PSMA PET/CT in treatment-naïve patients with prostate cancer: Which clinical parameters and risk stratification systems best predict PSMA-positive metastases? Prostate, 78(14), 1103-1110. https://doi.org/10.1002/pros.23685
MLA:
Rogasch, Julian M., et al. "Ga-68-PSMA PET/CT in treatment-naïve patients with prostate cancer: Which clinical parameters and risk stratification systems best predict PSMA-positive metastases?" Prostate 78.14 (2018): 1103-1110.
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