Department of Nuclear Medicine, Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey.
Department of Nuclear Medicine, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2024 Nov-Dec;43(6):500032. doi: 10.1016/j.remnie.2024.500032. Epub 2024 Aug 2.
The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies.
51 patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses.
29 (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P=.050), GLCM-sum variance (P=.019), and GLCM-cluster prominence (P=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P=.009) and GLCM-sum variance (P=.004) were found as independent predictors of BCR in the multivariate analysis.
Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.
本研究旨在探讨原发肿瘤纹理分析在预测接受根治性治疗的前列腺癌患者发生生化复发（BCR）中的价值。
本研究纳入了 51 例接受治疗前 [68Ga]Ga-PSMA-11 PET/CT 检查且接受根治性放疗（RT）或根治性前列腺切除术（RP）的前列腺腺癌患者。记录患者的人口统计学、临床病理学特征、BCR 发生情况和最后随访日期。使用 LifeX 程序从 PET/CT 图像中获取纹理和常规 PET 参数（最大标准化摄取值（SUVmax）、全病变 PSMA（TL-PSMA）和 PSMA 肿瘤体积（PSMA-TV））。使用 ROC 分析中的约登指数对参数进行分组。使用 Cox 回归分析确定预测 BCR 的因素。
29 例（56.9%）患者接受了原发性根治性 RT，其余 22 例（43.1%）患者接受了 RP。RP 中有 5 例（22.7%）和根治性 RT 中有 3 例（10.3%）患者在随访期间发生了 BCR。在单因素分析中，基于强度的最小灰度（P=.050）、GLCM 总和方差（P=.019）和 GLCM 聚类突出度（P=.050）与 BCR 相关。基于强度的最小灰度（P=.009）和 GLCM 总和方差（P=.004）在多因素分析中被发现是 BCR 的独立预测因素。
在接受根治性治疗的前列腺癌患者中，治疗前 [68Ga]Ga-PSMA PET 上的肿瘤异质性与 BCR 发生风险较高相关。
