Abstract：
OBJECTIVE: 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.
CONCLUSIONS: Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa 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.
CONCLUSIONS: Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.
摘要：
目的：本研究的目的是研究[68Ga]Ga-PSMAPET治疗前原发肿瘤纹理分析在预测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例前列腺腺癌患者，这些患者接受了治疗前[68Ga]Ga-PSMA-11PET/CT，并接受了确定性放疗（RT）或根治性前列腺切除术（RP）。人口统计,临床病理特征，BCR的存在,并记录患者的最后随访日期.质地和常规PET参数（最大标准化摄取值（SUVmax），总病变-PSMA（TL-PSMA），使用LifeX程序从PET/CT图像获得PSMA-肿瘤体积（PSMA-TV））。在ROC分析中使用Youden指数对参数进行分组。使用Cox回归分析确定预测BCR的因素。
结果：29例（56.9％）患者接受了主要治愈性RT，而其余22例（43.1％）患者经历了RP。在随访期间，有5例（22.7％）RP患者和3例（10.3％）治愈性RT患者发生了BCR。基于强度的最小灰度级（p=0.050），GLCM-和方差(p=0.019)，在单因素分析中，GLCM聚类突出(p=0.050)与BCR相关。在多变量分析中，基于强度的最小灰度（p=0.009）和GLCM和方差（p=0.004）被发现是BCR的独立预测因子。
结论：治疗前[68Ga]Ga-PSMAPET的肿瘤异质性与接受明确治疗的PCa患者BCR的高风险相关。
方法：本研究纳入了51例前列腺腺癌患者，这些患者接受了治疗前[68Ga]Ga-PSMA-11PET/CT，并接受了确定性放疗（RT）或根治性前列腺切除术（RP）。人口统计,临床病理特征，BCR的存在,并记录患者的最后随访日期.质地和常规PET参数（最大标准化摄取值（SUVmax），总病变-PSMA（TL-PSMA），使用LifeX程序从PET/CT图像获得PSMA-肿瘤体积（PSMA-TV））。在ROC分析中使用Youden指数对参数进行分组。使用Cox回归分析确定预测BCR的因素。
结果：29例（56.9％）患者接受了主要治愈性RT，而其余22例（43.1％）患者经历了RP。在随访期间，有5例（22.7％）RP患者和3例（10.3％）治愈性RT患者发生了BCR。基于强度的最小灰度级（p=0.050），GLCM-和方差(p=0.019)，在单因素分析中，GLCM聚类突出(p=0.050)与BCR相关。在多变量分析中，基于强度的最小灰度（p=0.009）和GLCM和方差（p=0.004）被发现是BCR的独立预测因子。
结论：治疗前[68Ga]Ga-PSMAPET的肿瘤异质性与接受明确治疗的PCa患者BCR的高风险相关。
