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AuthorRoberts, Matthew J.
AuthorMorton, Andrew
AuthorDonato, Peter
AuthorKyle, Samuel
AuthorPattison, David A.
AuthorThomas, Paul
AuthorCoughlin, Geoff
AuthorEsler, Rachel
AuthorDunglison, Nigel
AuthorGardiner, Robert A.
AuthorDoi, Suhail A.
AuthorEmmett, Louise
AuthorYaxley, John
Available date2020-11-08T05:20:05Z
Publication Date2020-01-01
Publication NameEuropean Journal of Nuclear Medicine and Molecular Imaging
Identifierhttp://dx.doi.org/10.1007/s00259-020-04944-2
CitationRoberts, M.J., Morton, A., Donato, P. et al. 68Ga-PSMA PET/CT tumour intensity pre-operatively predicts adverse pathological outcomes and progression-free survival in localised prostate cancer. Eur J Nucl Med Mol Imaging (2020). https://doi.org/10.1007/s00259-020-04944-2
ISSN1619-7070
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85088262772&origin=inward
URIhttp://hdl.handle.net/10576/16940
Abstract© 2020, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) improves prostate cancer staging. Intraprostatic PSMA intensity may predict clinically relevant oncological outcomes. The aim of this study was to investigate the relationship between intraprostatic PSMA intensity and adverse pathology outcomes, including biochemical progression-free survival (PFS) after radical prostatectomy. Methods: This is a cohort study of 71 patients with MRI-guided, biopsy-proven prostate cancer and pre-operative 68Ga-PSMA-11 PET/CT prior to radical prostatectomy (RP). Intraprostatic PSMA intensity was correlated to adverse pathology outcomes (Gleason score and upgrading from biopsy, pathological stage) and PFS using multivariate statistical analysis. Results: 68Ga-PSMA-11 PET/CT intensity in vivo predicted all of Gleason score on RP, upgrading from biopsy to RP histopathology, pathological stage, positive surgical margins and PFS. 74.6% (53/71) of patients were free from progression at a median follow-up of 19.5 months (0.4–48 months). Predictive accuracy was particularly enhanced by PSMA among patients with biopsy Gleason score ≤ 3 + 4 (n = 39) as the most significant predictor of PFS according to Cox-proportional hazards regression. Cox-regression adjusted survival analysis predicted a 5.48-fold increase in hazard for Gleason score ≤ 3 + 4 patients with high (SUVmax > 8) compared with low (SUVmax < 8) PSMA intensity. Conclusion: Intraprostatic 68Ga-PSMA-11 intensity is prognostic and may be a valuable new biomarker in localised prostate cancer, especially in men with biopsy-proven Gleason 3 + 4 disease considering an initial approach of active surveillance or focal therapy.
Languageen
PublisherSpringer
SubjectMagnetic resonance imaging
Positron emission tomography
Prostate cancer
Prostate specific membrane antigen, PSMA
Prostatectomy
Title68 Ga-PSMA PET/CT tumour intensity pre-operatively predicts adverse pathological outcomes and progression-free survival in localised prostate cancer
TypeArticle
ESSN1619-7089
dc.accessType Abstract Only


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