Matthew J Roberts1,2,3,4, Andrew Morton5, Peter Donato6,5, Samuel Kyle5,7, David A Pattison5,7, Paul Thomas5,7, Geoff Coughlin6, Rachel Esler6, Nigel Dunglison6, Robert A Gardiner6,8,9,10, Suhail A Doi11, Louise Emmett12,13, John Yaxley6,5. 1. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia. m.roberts2@uq.edu.au. 2. Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Australia. m.roberts2@uq.edu.au. 3. Department of Urology, Redcliffe Hospital, Brisbane, Australia. m.roberts2@uq.edu.au. 4. Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia. m.roberts2@uq.edu.au. 5. Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia. 6. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia. 7. Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia. 8. Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Australia. 9. Griffith University, Brisbane, Queensland, Australia. 10. Edith Cowan University, Joondalup, Western Australia. 11. Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar. 12. Department of Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia. 13. Faculty of Medicine, University of New South Wales, Sydney, Australia.
Abstract
PURPOSE: Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) improves prostate cancer staging. Intraprostatic PSMA intensity may predict clinically relevant oncological outcomes. The aim of this study was to investigate the relationship between intraprostatic PSMA intensity and adverse pathology outcomes, including biochemical progression-free survival (PFS) after radical prostatectomy. METHODS: This is a cohort study of 71 patients with MRI-guided, biopsy-proven prostate cancer and pre-operative 68Ga-PSMA-11 PET/CT prior to radical prostatectomy (RP). Intraprostatic PSMA intensity was correlated to adverse pathology outcomes (Gleason score and upgrading from biopsy, pathological stage) and PFS using multivariate statistical analysis. RESULTS: 68Ga-PSMA-11 PET/CT intensity in vivo predicted all of Gleason score on RP, upgrading from biopsy to RP histopathology, pathological stage, positive surgical margins and PFS. 74.6% (53/71) of patients were free from progression at a median follow-up of 19.5 months (0.4-48 months). Predictive accuracy was particularly enhanced by PSMA among patients with biopsy Gleason score ≤ 3 + 4 (n = 39) as the most significant predictor of PFS according to Cox-proportional hazards regression. Cox-regression adjusted survival analysis predicted a 5.48-fold increase in hazard for Gleason score ≤ 3 + 4 patients with high (SUVmax > 8) compared with low (SUVmax < 8) PSMA intensity. CONCLUSION: Intraprostatic 68Ga-PSMA-11 intensity is prognostic and may be a valuable new biomarker in localised prostate cancer, especially in men with biopsy-proven Gleason 3 + 4 disease considering an initial approach of active surveillance or focal therapy.
PURPOSE:Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) improves prostate cancer staging. Intraprostatic PSMA intensity may predict clinically relevant oncological outcomes. The aim of this study was to investigate the relationship between intraprostatic PSMA intensity and adverse pathology outcomes, including biochemical progression-free survival (PFS) after radical prostatectomy. METHODS: This is a cohort study of 71 patients with MRI-guided, biopsy-proven prostate cancer and pre-operative 68Ga-PSMA-11 PET/CT prior to radical prostatectomy (RP). Intraprostatic PSMA intensity was correlated to adverse pathology outcomes (Gleason score and upgrading from biopsy, pathological stage) and PFS using multivariate statistical analysis. RESULTS: 68Ga-PSMA-11 PET/CT intensity in vivo predicted all of Gleason score on RP, upgrading from biopsy to RP histopathology, pathological stage, positive surgical margins and PFS. 74.6% (53/71) of patients were free from progression at a median follow-up of 19.5 months (0.4-48 months). Predictive accuracy was particularly enhanced by PSMA among patients with biopsy Gleason score ≤ 3 + 4 (n = 39) as the most significant predictor of PFS according to Cox-proportional hazards regression. Cox-regression adjusted survival analysis predicted a 5.48-fold increase in hazard for Gleason score ≤ 3 + 4 patients with high (SUVmax > 8) compared with low (SUVmax < 8) PSMA intensity. CONCLUSION: Intraprostatic 68Ga-PSMA-11 intensity is prognostic and may be a valuable new biomarker in localised prostate cancer, especially in men with biopsy-proven Gleason 3 + 4 disease considering an initial approach of active surveillance or focal therapy.
Entities:
Keywords:
Magnetic resonance imaging; Positron emission tomography; Prostate cancer; Prostate specific membrane antigen, PSMA; Prostatectomy
Authors: Michel Bolla; Hein van Poppel; Bertrand Tombal; Kris Vekemans; Luigi Da Pozzo; Theo M de Reijke; Antony Verbaeys; Jean-François Bosset; Roland van Velthoven; Marc Colombel; Cees van de Beek; Paul Verhagen; Alphonsus van den Bergh; Cora Sternberg; Thomas Gasser; Geertjan van Tienhoven; Pierre Scalliet; Karin Haustermans; Laurence Collette Journal: Lancet Date: 2012-10-19 Impact factor: 79.321
Authors: Vladimir Mouraviev; Arnauld Villers; David G Bostwick; Thomas M Wheeler; Rodolfo Montironi; Thomas J Polascik Journal: BJU Int Date: 2011-04-13 Impact factor: 5.588
Authors: Jonathan I Epstein; Lars Egevad; Mahul B Amin; Brett Delahunt; John R Srigley; Peter A Humphrey Journal: Am J Surg Pathol Date: 2016-02 Impact factor: 6.394
Authors: Mattia Luca Piccinelli; Stefano Luzzago; Giulia Marvaso; Ekaterina Laukhtina; Noriyoshi Miura; Victor M Schuettfort; Keiichiro Mori; Abdulmajeed Aydh; Matteo Ferro; Francesco A Mistretta; Nicola Fusco; Giuseppe Petralia; Barbara A Jereczek-Fossa; Shahrokh F Shariat; Pierre I Karakiewicz; Ottavio de Cobelli; Gennaro Musi Journal: World J Urol Date: 2021-10-23 Impact factor: 4.226
Authors: Dennie Meijer; Pim J van Leeuwen; Maarten L Donswijk; Thierry N Boellaard; Ivo G Schoots; Henk G van der Poel; Harry N Hendrikse; Daniela E Oprea-Lager; André N Vis Journal: BJU Int Date: 2021-06-16 Impact factor: 5.969
Authors: Matthew J Roberts; Andrew Morton; Nathan Papa; Anthony Franklin; Sheliyan Raveenthiran; William J Yaxley; Geoffrey Coughlin; Troy Gianduzzo; Boon Kua; Louise McEwan; David Wong; Brett Delahunt; Lars Egevad; Hemamali Samaratunga; Nicholas Brown; Robert Parkinson; Louise Emmett; John W Yaxley Journal: Eur J Nucl Med Mol Imaging Date: 2022-03-17 Impact factor: 10.057
Authors: Venkata Avinash Chikatamarla; Satomi Okano; Peter Jenvey; Alexander Ansaldo; Matthew J Roberts; Stuart C Ramsay; Paul A Thomas; David A Pattison Journal: EJNMMI Res Date: 2021-12-20 Impact factor: 3.138
Authors: Yves J L Bodar; Hans Veerman; Dennie Meijer; Katelijne de Bie; Pim J van Leeuwen; Maarten L Donswijk; R Jeroen A van Moorselaar; N Harry Hendrikse; Ronald Boellaard; Daniela E Oprea-Lager; André N Vis Journal: BJU Int Date: 2022-03-12 Impact factor: 5.969