Association of Free-to-Total PSA Ratio and 18F-DCFPyL Prostate-Specific Membrane Antigen PET/CT Findings in Patients with Biochemical Recurrence After Radical Prostatectomy: A Prospective Single-Center Study

被引：0

作者：

Bernardino, Rui M. ^{[1
,2
]}

Lajkosz, Katherine ^{[3
]}

Yin, Leyi B. ^{[4
]}

Sayyid, Rashid K. ^{[1
]}

Wettstein, Marian ^{[1
]}

Randhawa, Harkanwal ^{[1
]}

Cockburn, Jessica G. ^{[1
]}

Ahmed, Sayeed ^{[1
]}

Thomassian, Rosita ^{[1
]}

Diamandis, Eleftherios ^{[5
]}

Metser, Ur ^{[6
]}

Berlin, Alejandro ^{[7
,8
]}

Fleshner, Neil E. ^{[1
]}

机构：

[1] Univ Toronto, Div Urol, Dept Surg Oncol, Princess Margaret Canc Ctr, Toronto, ON, Canada

[2] Nova Med Sch, Computat & Expt Biol Grp, Lisbon, Portugal

[3] Univ Hlth Network, Dept Biostat, Toronto, ON, Canada

[4] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada

[5] Mt Sinai Hosp, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[6] Univ Hlth Network, Joint Dept Med Imaging, Toronto, ON, Canada

[7] Univ Toronto, Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada

[8] Univ Toronto, Princess Margaret Canc Ctr, Radiat Med Program, Toronto, ON, Canada

来源：

JOURNAL OF NUCLEAR MEDICINE | 2024年 / 65卷 / 11期

关键词：

prostatic neoplasms; positron emission tomography; metastases; lymph nodes; CANCER; OUTCOMES; METASTASES; MEN;

D O I：

10.2967/jnumed.124.267877

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

In Canada and across the globe, access to PSMA PET/CT is limited and expensive. For patients with biochemical recurrence (BCR) after treatment for prostate cancer, novel strategies are needed to better stratify patients who may or may not benefit from a PSMA PET scan. The role of the free-to-total prostate-specific antigen (PSA) ratio (FPSAR) in posttreatment prostate cancer, specifically in the PSMA PET/CT era, remains unknown. Our aim in this study was to determine the association of FPSAR in patients referred for F-18-DCFPyL PSMA PET/CT in the BCR setting and assess the correlation between FPSAR and F-18-DCFPyL PSMA PET/CT positivity (local recurrence or distant metastases). Methods: This prospective study included 137 patients who were referred for F-18-DCFPyL PSMA PET/CT and had BCR with a total PSA of less than 1 ng/mL after radical prostatectomy (RP) (including adjuvant or salvage radiotherapy). Blood samples were collected on the day of F-18-DCFPyL PSMA PET/CT. FPSAR was categorized as less than 0.10 or as 0.10 or more. A positive F-18-DCFPyL PSMA PET/CT scan was defined by a PROMISE classification lesion score of 2 or 3, irrespective of the site of increased tracer uptake (e.g., prostate, pelvic nodes, bone, or viscera). Results: Overall, 137 blood samples of patients with BCR after RP were analyzed to calculate FPSAR. The median age at F-18-DCFPyL PSMA PET/CT was 68.6 y (interquartile range, 63.0-72.4 y), and the median PSA at F-18-DCFPyL PSMA PET/CT was 0.3 ng/mL (interquartile range, 0.3-0.6 ng/mL). Eighty-six patients (62.8%) had an FPSAR of less than 0.10, whereas 51 patients (37.2%) had an FPSAR of 0.10 or more. An FPSAR of 0.10 or more was identified as an independent predictor of a positive F-18-DCFPyL PSMA PET/CT scan, with an odds ratio of 6.99 (95% CI, 2.96-16.51; P < 0.001). Conclusion: An FPSAR of 0.10 or more after RP independently correlated with increased odds of a positive F-18-DCFPyL PSMA PET/CT scan among BCR post-RP patients. These findings may offer an inexpensive method by which to triage access to F-18-DCFPyL PSMA PET/CT in jurisdictions where availability is not replete.

引用

页码：1731 / 1739

页数：9

共 17 条

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