Timo F W Soeterik, Joris G Heetman, Rick Hermsen, Lieke Wever, Jules Lavalaye, Maarten Vinken, Clinton D Bahler, Courtney Yong, Mark Tann, Claudia Kesch, Robert Seifert, Tugce Telli, Peter Ka-Fung Chiu, Kwan Kit Wu, Fabio Zattoni, Laura Evangelista, Emma Segalla, Antonio Barone, Francesco Ceci, Pawel Rajwa, Giancarlo Marra, Elio Mazzone, Jean-Paul A Van Basten, Harm H E Van Melick, Roderick C N Van den Bergh, Giorgio Gandaglia
{"title":"PSMA PET定量参数与病理ISUP分级的关联：国际多中心分析。","authors":"Timo F W Soeterik, Joris G Heetman, Rick Hermsen, Lieke Wever, Jules Lavalaye, Maarten Vinken, Clinton D Bahler, Courtney Yong, Mark Tann, Claudia Kesch, Robert Seifert, Tugce Telli, Peter Ka-Fung Chiu, Kwan Kit Wu, Fabio Zattoni, Laura Evangelista, Emma Segalla, Antonio Barone, Francesco Ceci, Pawel Rajwa, Giancarlo Marra, Elio Mazzone, Jean-Paul A Van Basten, Harm H E Van Melick, Roderick C N Van den Bergh, Giorgio Gandaglia","doi":"10.1007/s00259-024-06847-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess if PSMA PET quantitative parameters are associated with pathologic ISUP grade group (GG) and upgrading/downgrading.</p><p><strong>Methods: </strong>PCa patients undergoing radical prostatectomy with or without pelvic lymph node dissection staged with preoperative PSMA PET at seven referral centres worldwide were evaluated. PSMA PET parameters which included SUV<sub>max</sub>, PSMA<sub>volume</sub>, and total PSMA accumulation (PSMA<sub>total</sub>) were collected. Multivariable logistic regression evaluated the association between PSMA PET quantified parameters and surgical ISUP GG. Decision-tree analysis was performed to identify discriminative thresholds for all three parameters related to the five ISUP GGs The ROC-derived AUC was used to determine whether the inclusion of PSMA quantified parameters improved the ability of multivariable models to predict ISUP GG ≥ 4.</p><p><strong>Results: </strong>A total of 605 patients were included. Overall, 2%, 37%, 37%, 10% and 13% patients had pathologic ISUP GG1, 2, 3, 4, and 5, respectively. At multivariable analyses, all three parameters SUV<sub>max</sub>, PSMA<sub>volume</sub> and PSMA<sub>total</sub> were associated with GG ≥ 4 at surgical pathology after accounting for PSA and clinical T stage based on DRE, hospital and radioligand (all p < 0.05). Addition of all three parameters significantly improved the discrimination of clinical models in predicting GG ≥ 4 from 68% (95%CI 63 - 74) to 74% (95%CI 69 - 79) for SUV<sub>max</sub>, 72% (95%CI 67 - 76) for PSMA<sub>volume</sub>, 74% (70 - 79) for PSMA<sub>total</sub> and 75% (95%CI 71 - 80) when all parameters were included (all p < 0.05). Decision-tree analysis resulted in thresholds that discriminate between GG (SUV<sub>max</sub> 0-6.5, 6.5-15, 15-28, > 28, PSMA<sub>vol</sub> 0-2, 2-9, 9-20 and > 20 and PSMA<sub>total</sub> 0-12, 12-98 and > 98). PSMA<sub>volume</sub> was significantly associated with GG upgrading (OR 1.03 95%CI 1.01 - 1.05). In patients with biopsy GG1-3, PSMA<sub>volume</sub> ≥ 2 was significantly associated with higher odds for upgrading to ISUP GG ≥ 4, compared to PSMA<sub>volume</sub> < 2 (OR 6.36, 95%CI 1.47 - 27.6).</p><p><strong>Conclusion: </strong>Quantitative PSMA PET parameters are associated with surgical ISUP GG and upgrading. We propose clinically relevant thresholds of these parameters which can improve in PCa risk stratification in daily clinical practice.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"314-325"},"PeriodicalIF":8.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599533/pdf/","citationCount":"0","resultStr":"{\"title\":\"The association of quantitative PSMA PET parameters with pathologic ISUP grade: an international multicenter analysis.\",\"authors\":\"Timo F W Soeterik, Joris G Heetman, Rick Hermsen, Lieke Wever, Jules Lavalaye, Maarten Vinken, Clinton D Bahler, Courtney Yong, Mark Tann, Claudia Kesch, Robert Seifert, Tugce Telli, Peter Ka-Fung Chiu, Kwan Kit Wu, Fabio Zattoni, Laura Evangelista, Emma Segalla, Antonio Barone, Francesco Ceci, Pawel Rajwa, Giancarlo Marra, Elio Mazzone, Jean-Paul A Van Basten, Harm H E Van Melick, Roderick C N Van den Bergh, Giorgio Gandaglia\",\"doi\":\"10.1007/s00259-024-06847-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess if PSMA PET quantitative parameters are associated with pathologic ISUP grade group (GG) and upgrading/downgrading.</p><p><strong>Methods: </strong>PCa patients undergoing radical prostatectomy with or without pelvic lymph node dissection staged with preoperative PSMA PET at seven referral centres worldwide were evaluated. PSMA PET parameters which included SUV<sub>max</sub>, PSMA<sub>volume</sub>, and total PSMA accumulation (PSMA<sub>total</sub>) were collected. Multivariable logistic regression evaluated the association between PSMA PET quantified parameters and surgical ISUP GG. Decision-tree analysis was performed to identify discriminative thresholds for all three parameters related to the five ISUP GGs The ROC-derived AUC was used to determine whether the inclusion of PSMA quantified parameters improved the ability of multivariable models to predict ISUP GG ≥ 4.</p><p><strong>Results: </strong>A total of 605 patients were included. Overall, 2%, 37%, 37%, 10% and 13% patients had pathologic ISUP GG1, 2, 3, 4, and 5, respectively. At multivariable analyses, all three parameters SUV<sub>max</sub>, PSMA<sub>volume</sub> and PSMA<sub>total</sub> were associated with GG ≥ 4 at surgical pathology after accounting for PSA and clinical T stage based on DRE, hospital and radioligand (all p < 0.05). Addition of all three parameters significantly improved the discrimination of clinical models in predicting GG ≥ 4 from 68% (95%CI 63 - 74) to 74% (95%CI 69 - 79) for SUV<sub>max</sub>, 72% (95%CI 67 - 76) for PSMA<sub>volume</sub>, 74% (70 - 79) for PSMA<sub>total</sub> and 75% (95%CI 71 - 80) when all parameters were included (all p < 0.05). Decision-tree analysis resulted in thresholds that discriminate between GG (SUV<sub>max</sub> 0-6.5, 6.5-15, 15-28, > 28, PSMA<sub>vol</sub> 0-2, 2-9, 9-20 and > 20 and PSMA<sub>total</sub> 0-12, 12-98 and > 98). PSMA<sub>volume</sub> was significantly associated with GG upgrading (OR 1.03 95%CI 1.01 - 1.05). In patients with biopsy GG1-3, PSMA<sub>volume</sub> ≥ 2 was significantly associated with higher odds for upgrading to ISUP GG ≥ 4, compared to PSMA<sub>volume</sub> < 2 (OR 6.36, 95%CI 1.47 - 27.6).</p><p><strong>Conclusion: </strong>Quantitative PSMA PET parameters are associated with surgical ISUP GG and upgrading. We propose clinically relevant thresholds of these parameters which can improve in PCa risk stratification in daily clinical practice.</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\" \",\"pages\":\"314-325\"},\"PeriodicalIF\":8.6000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599533/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-024-06847-y\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-024-06847-y","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The association of quantitative PSMA PET parameters with pathologic ISUP grade: an international multicenter analysis.
Purpose: To assess if PSMA PET quantitative parameters are associated with pathologic ISUP grade group (GG) and upgrading/downgrading.
Methods: PCa patients undergoing radical prostatectomy with or without pelvic lymph node dissection staged with preoperative PSMA PET at seven referral centres worldwide were evaluated. PSMA PET parameters which included SUVmax, PSMAvolume, and total PSMA accumulation (PSMAtotal) were collected. Multivariable logistic regression evaluated the association between PSMA PET quantified parameters and surgical ISUP GG. Decision-tree analysis was performed to identify discriminative thresholds for all three parameters related to the five ISUP GGs The ROC-derived AUC was used to determine whether the inclusion of PSMA quantified parameters improved the ability of multivariable models to predict ISUP GG ≥ 4.
Results: A total of 605 patients were included. Overall, 2%, 37%, 37%, 10% and 13% patients had pathologic ISUP GG1, 2, 3, 4, and 5, respectively. At multivariable analyses, all three parameters SUVmax, PSMAvolume and PSMAtotal were associated with GG ≥ 4 at surgical pathology after accounting for PSA and clinical T stage based on DRE, hospital and radioligand (all p < 0.05). Addition of all three parameters significantly improved the discrimination of clinical models in predicting GG ≥ 4 from 68% (95%CI 63 - 74) to 74% (95%CI 69 - 79) for SUVmax, 72% (95%CI 67 - 76) for PSMAvolume, 74% (70 - 79) for PSMAtotal and 75% (95%CI 71 - 80) when all parameters were included (all p < 0.05). Decision-tree analysis resulted in thresholds that discriminate between GG (SUVmax 0-6.5, 6.5-15, 15-28, > 28, PSMAvol 0-2, 2-9, 9-20 and > 20 and PSMAtotal 0-12, 12-98 and > 98). PSMAvolume was significantly associated with GG upgrading (OR 1.03 95%CI 1.01 - 1.05). In patients with biopsy GG1-3, PSMAvolume ≥ 2 was significantly associated with higher odds for upgrading to ISUP GG ≥ 4, compared to PSMAvolume < 2 (OR 6.36, 95%CI 1.47 - 27.6).
Conclusion: Quantitative PSMA PET parameters are associated with surgical ISUP GG and upgrading. We propose clinically relevant thresholds of these parameters which can improve in PCa risk stratification in daily clinical practice.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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