Ruohua Chen1, Yining Wang1, Yiping Shi1, Yinjie Zhu2, Lian Xu1, Gang Huang3,4, Jianjun Liu5. 1. Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3. Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. huanggang2802@163.com. 4. Shanghai University of Medicine & Health Sciences, Shanghai, China. huanggang2802@163.com. 5. Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. liujjrj@sina.com.
Abstract
PURPOSE: 68Ga-PSMA PET/CT has a high detection rate in prostate cancer patients with biochemical recurrence (BCR). However, few studies have reported other imaging methods for BCR with negative 68Ga-PSMA PET/CT findings. We investigated the value of 18F-FDG compared with 68Ga-PSMA and identified BCR patients with 68Ga-PSMA-negative findings who are most likely to benefit from 18F-FDG PET/CT. METHODS: Seventy-two BCR patients with negative 68Ga-PSMA PET/CT findings were retrospectively identified from 510 patients who underwent concomitant 68Ga-PSMA and 18F-FDG PET/CT between June 2018 and August 2020. Patients were categorised into groups with positive or negative 18F-FDG PET/CT findings. Differences in patients' characteristics between these two groups and predictors of positive 18F-FDG findings were analysed. RESULTS: The detection rate of 18F-FDG PET/CT was 16.7% (12/72) in BCR patients with 68Ga-PSMA-negative findings. PSA and Gleason score were significantly higher in the 18F-FDG-positive group than in the 18F-FDG-negative group (P < 0.001 and P < 0.001, respectively). A multivariate analysis indicated that PSA (PSA ≥2.3 ng/mL) and Gleason score (Gleason score ≥ 8) correlated with 18F-FDG-positive findings (P < 0.001 and P = 0.015, respectively). The probabilities of 18F-FDG-positive findings in the low-potential (PSA <2.3 ng/mL and Gleason score <8), moderate-potential (PSA <2.3 ng/mL and Gleason score ≥ 8 or PSA ≥2.3 ng/mL and Gleason score <8), and high-potential (PSA ≥2.3 ng/mL and Gleason score ≥ 8) groups were 0%, 11.5%, and 90.0%, respectively (P < 0.001). CONCLUSION: PSA level and Gleason score are independent predictors of 18F-FDG-positive findings, and BCR patients with 68Ga-PSMA-negative findings with high PSA and Gleason score are most likely to benefit from 18F-FDG PET/CT.
PURPOSE: 68Ga-PSMA PET/CT has a high detection rate in prostate cancerpatients with biochemical recurrence (BCR). However, few studies have reported other imaging methods for BCR with negative 68Ga-PSMA PET/CT findings. We investigated the value of 18F-FDG compared with 68Ga-PSMA and identified BCR patients with 68Ga-PSMA-negative findings who are most likely to benefit from 18F-FDG PET/CT. METHODS: Seventy-two BCR patients with negative 68Ga-PSMA PET/CT findings were retrospectively identified from 510 patients who underwent concomitant 68Ga-PSMA and 18F-FDG PET/CT between June 2018 and August 2020. Patients were categorised into groups with positive or negative 18F-FDG PET/CT findings. Differences in patients' characteristics between these two groups and predictors of positive 18F-FDG findings were analysed. RESULTS: The detection rate of 18F-FDG PET/CT was 16.7% (12/72) in BCR patients with 68Ga-PSMA-negative findings. PSA and Gleason score were significantly higher in the 18F-FDG-positive group than in the 18F-FDG-negative group (P < 0.001 and P < 0.001, respectively). A multivariate analysis indicated that PSA (PSA ≥2.3 ng/mL) and Gleason score (Gleason score ≥ 8) correlated with 18F-FDG-positive findings (P < 0.001 and P = 0.015, respectively). The probabilities of 18F-FDG-positive findings in the low-potential (PSA <2.3 ng/mL and Gleason score <8), moderate-potential (PSA <2.3 ng/mL and Gleason score ≥ 8 or PSA ≥2.3 ng/mL and Gleason score <8), and high-potential (PSA ≥2.3 ng/mL and Gleason score ≥ 8) groups were 0%, 11.5%, and 90.0%, respectively (P < 0.001). CONCLUSION: PSA level and Gleason score are independent predictors of 18F-FDG-positive findings, and BCR patients with 68Ga-PSMA-negative findings with high PSA and Gleason score are most likely to benefit from 18F-FDG PET/CT.
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