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Higher Preoperative Maximum Standardised Uptake Values (SUV max ) Are Associated with Higher Biochemical Recurrence Rates after Robot-Assisted Radical Prostatectomy for [ 68 Ga]Ga-PSMA-11 and [ 18 F]DCFPyL Positron Emission Tomography/Computed Tomography.

Katelijne C C de BieHans VeermanYves J L BodarDennie MeijerPim J van LeeuwenHenk G van der PoelMaarten L DonswijkAndré N VisDaniela E Oprea-Lager
Published in: Diagnostics (Basel, Switzerland) (2023)
This study aimed to investigate the association between the 68 Ga- or 18 F-radiolabeled prostate-specific membrane antigen (PSMA) tracer expression, represented by the maximum standardised uptake value (SUV max ) of the dominant intraprostatic lesion, and biochemical recurrence (BCR) in primary prostate cancer (PCa) patients prior to robot-assisted radical prostatectomy (RARP). This was a retrospective, multi-centre cohort study of 446 patients who underwent [ 68 Ga]Ga-PSMA-11 ( n = 238) or [ 18 F]DCFPyL ( n = 206) Positron Emission Tomography/Computed Tomography (PET/CT) imaging prior to RARP. SUV max was measured in the dominant intraprostatic PCa lesions. [ 18 F]DCFPyL patients were scanned 60 ([ 18 F]DCFPyL-60; n = 106) or 120 ([ 18 F]DCFPyL-120; n = 120) minutes post-injection of a radiotracer and were analysed separately. To normalise the data, SUV max was log transformed for further analyses. During a median follow-up of 24 months, 141 (30.4%) patients experienced BCR. Log 2 SUV max was a significant predictor for BCR ( p < 0.001). In the multivariable analysis accounting for these preoperative variables: initial prostate-specific antigen (PSA), radiologic tumour stage (mT), the biopsy International Society of Urological Pathology grade group (bISUP) and the prostate imaging and reporting data system (PI-RADS), Log 2 SUV max was found to be an independent predictor for BCR in [ 68 Ga]Ga-PSMA-11 (HR 1.32, p = 0.04) and [ 18 F]DCFPyL-120 PET/CT scans (HR 1.55, p = 0.04), but not in [ 18 F]DCFPyL-60 ones (HR 0.92, p = 0.72). The PSMA expression of the dominant intraprostatic lesion proved to be an independent predictor for BCR in patients with primary PCa who underwent [ 68 Ga]Ga-PSMA-11 or [ 18 F]DCFPyL-120 PET/CT scans, but not in those who underwent [ 18 F]DCFPyL-60 PET/CT scans.
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