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.
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。