Zhou Shuoming, Liu Tiantian, Zhu Ziqiang, Zhang Lin, Qian Subo, Fu Hongliang, Cao Qifeng, Kang Jian
Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Urology, Anhui Provincial Children's Hospital/Children's Hospital of Fudan University (Affiliated Anhui Branch), Hefei, China.
Front Oncol. 2022 Feb 3;12:800904. doi: 10.3389/fonc.2022.800904. eCollection 2022.
F-DCFPyL prostate-specific membrane antigen (PSMA) PET/CT is commonly applied to locate lesions of prostate cancer (PCa), but its diagnostic function of quantitative parameters is ignored. Our study evaluates the parameters of intraprostatic PSMA uptake in patients newly diagnosed with PCa and explores their predictive value in risk classification, which is similar to D'Amico criteria.
We quantified the maximal standardized uptake value (SUVmax), mean SUV (SUVmean), total lesion (TL)-PSMA, prostate/muscle (P/M) ratio of the primary tumor, and PSMA-derived tumor volume (PSMA-TV) from 62 patients with histologically proven PCa. Patients newly diagnosed with PCa were allocated into risk groups (at low, intermediate, and high risk, respectively) in accordance with D'Amico criteria. Afterwards, the five parameters mentioned above among three different risk groups were compared, and their predictive values in the risk classification of PCa were explored.
Significantly decreased levels of SUVmax, SUVmean, TL-PSMA, and P/M ratio were observed in the risk groups of low or intermediate or both, compared with the high-risk group. However, only the P/M ratio significantly elevated in patients with intermediate risk [mean ± SD (median): 46.58 ± 9.74 (45.27), = 0.042] or high risk [98.95 ± 38.83 (97.52), < 0.001], compared with low-risk patients [12.33 ± 5.93 (9.81)]. When P/M ratio was used to distinguish between low-risk and intermediate-risk patients, its -statistics was 0.660. On the other hand, when distinguishing between intermediate-risk and high-risk groups, the -statistics of P/M ratio was 0.667. Finally, when P/M ratio was used to distinguish between low-risk and high-risk patients, the -statistics was 0.969. P/M ratio had a positive correlation with prostate-specific antigen in all enrolled PCa patients.
The quantitative parameters of F-DCFPyL PET/CT, including SUVmax, SUVmean, and P/M ratio, might assist in distinguishing low-risk or intermediate-risk groups from the high-risk group. Of these parameters, P/M ratio appears to be the better promising parameter for risk classification of prostate cancer than SUVmax.
F-DCFPyL前列腺特异性膜抗原（PSMA）PET/CT常用于定位前列腺癌（PCa）病灶，但其定量参数的诊断功能被忽视。我们的研究评估了新诊断为PCa患者的前列腺内PSMA摄取参数，并探讨其在风险分类中的预测价值，该价值与达米科标准类似。
我们对62例经组织学证实为PCa的患者的最大标准化摄取值（SUVmax）、平均SUV（SUVmean）、总病灶（TL）-PSMA、原发肿瘤的前列腺/肌肉（P/M）比值以及PSMA衍生肿瘤体积（PSMA-TV）进行了量化。新诊断为PCa的患者根据达米科标准被分为风险组（分别为低、中、高风险）。之后，比较了三个不同风险组中上述五个参数，并探讨了它们在PCa风险分类中的预测价值。
与高风险组相比，低风险组或中风险组或两者的SUVmax、SUVmean、TL-PSMA和P/M比值水平均显著降低。然而，与低风险患者[12.33±5.93（9.81）]相比，中风险患者[均值±标准差（中位数）：46.58±9.74（45.27），P = 0.042]或高风险患者[98.95±38.83（97.52），P < 0.001]的P/M比值仅显著升高。当用P/M比值区分低风险和中风险患者时，其t统计量为0.660。另一方面，当区分中风险和高风险组时，P/M比值的t统计量为0.667。最后，当用P/M比值区分低风险和高风险患者时，t统计量为0.969。在所有纳入的PCa患者中，P/M比值与前列腺特异性抗原呈正相关。
F-DCFPyL PET/CT的定量参数，包括SUVmax、SUVmean和P/M比值，可能有助于将低风险或中风险组与高风险组区分开来。在这些参数中，与SUVmax相比，P/M比值似乎是前列腺癌风险分类中更有前景的参数。
