Vural Topuz Özge, Aksu Ayşegül
Department of Nuclear Medicine, University of Health Sciences, Başakşehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Department of Nuclear Medicine, Atatürk Training and Research Hospital, İzmir Kâtip Çelebi University, Izmir, Türkiye.
World J Nucl Med. 2024 Jun 14;23(4):227-233. doi: 10.1055/s-0044-1787733. eCollection 2024 Dec.
This article evaluates whether parameters derived from the gallium-68-labeled prostate-specific membrane antigen ( Ga-PSMA) positron emission tomography/computed tomography (PET/CT) imaging studies of primary prostate cancer (PCa) lesions were associated with Gleason score (GS), D'Amico risk class, Candiolo nomograms, and the metastatic status of the disease. We retrospectively evaluated newly diagnosed PCa patients who underwent Ga-PSMA PET/CT before therapy. Age, baseline serum prostate-specific antigen (PSA), and metastatic status were recorded. Maximal standardized uptake value (SUVmax), mean SUV (SUVmean), total lesion PSMA (TL-PSMA), and PSMA-derived tumor volume (PSMA-TV) were analyzed. The patients were grouped according to GS (GS ≤ 7 and GS ≥ 8), D'Amico risk classes (low intermediate and high-risk), and also based on their results with the Candiolo nomogram which normally creates five risk classes. For Candiolo classes, very-low risk and low-risk patients were pooled into the low-risk Candiolo (LRC) group, high and very high-risk patients were pooled into the high-risk Candiolo (HRC) group. The intermediate-risk Candiolo group was utilized as-is (IRC). Mean age was 67 ± 8 years, median PSA value was 14.3 (3-211). There were 82 patients with GS ≤ 7 and 38 patients with GS ≥ 8; intermediate D'Amico class comprised 32 patients, while the high D'Amico class comprised 88 patients. For Candiolo, there were 23 LRC, 40 IRC, and 57 HRC patients. PSMA-positive metastases were detected in 44 (36.7%) patients. The SUVmean, SUVmax, PSMA-TV, and TL-PSMA values of the primary tumor demonstrated significant differences when compared according to classifications for GS, D'Amico, LRC versus HRC, and metastatic versus nonmetastatic patients. Of note, TL-PSMA was the only parameter that varied significantly among all risk groups. Primary tumor parameters obtained from baseline Ga-PSMA PET/CT are useful to distinguish PCa patients in terms of GS, D'Amico, Candiolo nomogram, and metastatic states. TL-PSMA appears to be the best parameter as it is the only parameter that can distinguish all risk groups from each other.
本文评估了从原发性前列腺癌（PCa）病变的镓68标记前列腺特异性膜抗原（Ga-PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）成像研究中得出的参数是否与 Gleason 评分（GS）、达米科风险分类、坎迪奥洛列线图以及疾病的转移状态相关。
我们回顾性评估了治疗前接受 Ga-PSMA PET/CT 的新诊断 PCa 患者。记录了年龄、基线血清前列腺特异性抗原（PSA）和转移状态。分析了最大标准化摄取值（SUVmax）、平均 SUV（SUVmean）、总病变 PSMA（TL-PSMA）和 PSMA 衍生肿瘤体积（PSMA-TV）。患者根据 GS（GS≤7 和 GS≥8）、达米科风险分类（低、中、高风险）进行分组，并且还根据他们在通常创建五个风险类别的坎迪奥洛列线图中的结果进行分组。对于坎迪奥洛分类，极低风险和低风险患者合并为低风险坎迪奥洛（LRC）组，高风险和极高风险患者合并为高风险坎迪奥洛（HRC）组。中风险坎迪奥洛组按原样使用（IRC）。
平均年龄为 67±8 岁，PSA 中位数为 14.3（3 - 211）。有 82 例 GS≤7 的患者和 38 例 GS≥8 的患者；达米科中级组包括 32 例患者，而达米科高级组包括 88 例患者。对于坎迪奥洛分类，有 23 例 LRC 患者、40 例 IRC 患者和 57 例 HRC 患者。在 44 例（36.7%）患者中检测到 PSMA 阳性转移。根据 GS、达米科、LRC 与 HRC 以及转移与非转移患者的分类进行比较时，原发性肿瘤的 SUVmean、SUVmax、PSMA-TV 和 TL-PSMA 值显示出显著差异。值得注意的是，TL-PSMA 是所有风险组中唯一有显著差异的参数。
从基线 Ga-PSMA PET/CT 获得的原发性肿瘤参数有助于根据 GS、达米科、坎迪奥洛列线图和转移状态区分 PCa 患者。TL-PSMA 似乎是最佳参数，因为它是唯一能够区分所有风险组的参数。
