Association of prostate-specific antigen kinetics with gallium-68 prostate-specific membrane antigen PET/computed tomography positivity in biochemical recurrence after radical prostatectomy.

IF 1.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Nuclear Medicine Communications Pub Date : 2026-08-04 DOI:10.1097/MNM.0000000000002225

Mounish Nuthalapati, Tanmay Patravale, Nazareth Solomon, Arun Ramdas Menon, Ginil Kumar Pooleri

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引用次数: 0

Abstract

Introduction: Biochemical recurrence (BCR) after radical prostatectomy occurs in 20-40% of patients. Prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) is the preferred imaging modality for recurrence, but detection rates decline at low prostate-specific antigen (PSA) levels. The role of PSA kinetics in postradical prostatectomy BCR remains unclear. We evaluated the association between PSA kinetics and PSMA PET/CT positivity in postradical prostatectomy BCR.

Materials and methods: We retrospectively analyzed postradical prostatectomy patients (2013-2024) who developed BCR and underwent 68Ga-PSMA PET/CT. Patients with prior therapy, PSA persistence, inadequate follow-up, or non-PSMA imaging were excluded. Clinicopathological and PSA kinetic variables were compared between groups. Logistic regression assessed associations with PET positivity, and receiver operating characteristic (ROC) analysis identified exploratory cut-offs.

Results: Of 973 men who underwent radical prostatectomy, 64 met the inclusion criteria. Nineteen (29.7%) had positive and 45 (70.3%) had negative scans. Baseline characteristics were comparable. Median PSA at imaging was 0.30 ng/ml. PET-positive patients had higher PSA velocity (PSAV) (0.58 vs. 0.27 ng/ml/year; P = 0.020) and shorter PSA doubling time (PSADT) (3.23 vs. 5.80 months; P = 0.009). On univariable analysis, PSAV [odds ratio (OR): 3.31, P = 0.027), PSADT (OR: 0.86, P = 0.050), and PSA at imaging (OR: 10.68, P = 0.032) were associated with PET positivity. ROC analysis showed moderate discrimination for PSADT (AUC: 0.71) and PSAV (AUC: 0.69).

Conclusion: Shorter PSADT and higher PSAV predicted PSMA PET positivity in men with BCR after radical prostatectomy. Exploratory cut-offs of PSADT less than 3.9 months and PSAV more than 0.54 ng/ml/year were identified but require external validation.

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前列腺特异性抗原动力学与镓-68前列腺特异性膜抗原PET/计算机断层扫描阳性在根治性前列腺切除术后生化复发中的关系

导读：根治性前列腺切除术后生化复发（BCR）发生率为20-40%。前列腺特异性膜抗原（PSMA） PET/计算机断层扫描（CT）是复发的首选成像方式，但低前列腺特异性抗原（PSA）水平的检出率下降。PSA动力学在前列腺切除术后BCR中的作用尚不清楚。我们评估前列腺切除术后BCR中PSA动力学与PSMA PET/CT阳性之间的关系。材料和方法：我们回顾性分析前列腺切除术后发生BCR并接受68Ga-PSMA PET/CT检查的患者（2013-2024年）。排除了既往治疗、PSA持续存在、随访不充分或非psma成像的患者。比较两组患者的临床病理及PSA动力学指标。逻辑回归评估了与PET阳性的相关性，受试者工作特征（ROC）分析确定了探索性截断点。结果：973例接受根治性前列腺切除术的男性中，64例符合纳入标准。阳性19例（29.7%），阴性45例（70.3%）。基线特征具有可比性。成像时中位PSA为0.30 ng/ml。pet阳性患者PSA速度（PSAV）较高（0.58 vs. 0.27 ng/ml/年，P = 0.020）， PSA倍增时间（PSADT）较短（3.23 vs. 5.80个月，P = 0.009）。在单变量分析中，PSAV[比值比（OR）： 3.31, P = 0.027]、PSADT （OR: 0.86, P = 0.050）和成像时PSA （OR: 10.68, P = 0.032）与PET阳性相关。ROC分析显示PSADT （AUC: 0.71）和PSAV （AUC: 0.69）存在中度差异。结论：较短的PSADT和较高的PSAV可预测BCR患者根治性前列腺切除术后PSMA PET阳性。确定了PSADT小于3.9个月和PSAV大于0.54 ng/ml/年的探索性截止值，但需要外部验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nuclear Medicine Communications 医学-核医学

CiteScore

2.20

自引率

6.70%

发文量

212

审稿时长

3-8 weeks

期刊介绍： Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.