治疗前[68Ga]Ga-PSMA PET/CT 预测前列腺癌生化复发的原发肿瘤异质性

Revista espanola de medicina nuclear e imagen molecular Pub Date : 2024-11-01 DOI:10.1016/j.remnie.2024.500032

Seda Gülbahar Ateş , Bedriye Büşra Demirel , Esra Kekilli , Erdem Öztürk , Gülin Uçmak

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引用次数: 0

摘要

目的：本研究旨在研究治疗前[68Ga]Ga-PSMA PET中原发肿瘤的纹理分析在预测接受明确治疗的前列腺癌患者生化复发（BCR）发展中的价值。方法：本研究纳入了51例接受治疗前[68Ga]Ga-PSMA-11 PET/CT检查并接受明确放疗（RT）或根治性前列腺切除术（RP）的前列腺腺癌患者。研究人员记录了患者的人口统计学特征、临床病理学特征、是否存在 BCR 以及最后一次随访日期。使用LifeX程序从PET/CT图像中获取纹理参数和常规PET参数（最大标准化摄取值（SUVmax）、总病灶-PSMA（TL-PSMA）和PSMA-肿瘤体积（PSMA-TV））。在 ROC 分析中使用尤登指数对参数进行分组。结果：29 例（56.9%）患者接受了初治性 RT，其余 22 例（43.1%）患者接受了 RP。在随访期间，5 例（22.7%）RP 患者和 3 例（10.3%）根治性 RT 患者出现了 BCR。INTENSITY-BASED-minimum grey level（P = 0.050）、GLCM-sum variance（P = 0.019）和 GLCM-cluster prominence（P = 0.050）在单变量分析中与 BCR 相关。在多变量分析中发现，基于强度的最小灰度（p = 0.009）和 GLCM 总方差（p = 0.004）是 BCR 的独立预测因素：结论：治疗前[68Ga]Ga-PSMA PET显示的肿瘤异质性与接受明确疗法的PCa患者发生BCR的高风险有关。

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Primary tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET/CT for the prediction of biochemical recurrence in prostate cancer

Purpose

The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies.

Methods

51 patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses.

Results

29 (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P = .050), GLCM-sum variance (P = .019), and GLCM-cluster prominence (P = .050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P = .009) and GLCM-sum variance (P = .004) were found as independent predictors of BCR in the multivariate analysis.

Conclusion

Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.

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Revista espanola de medicina nuclear e imagen molecular

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