The Added Value of Volumetric Parameters in PSMA PET/CT In Follow-Up of Patients with Prostate Cancer

Abstract

Background: Prostate cancer, the 2nd most frequent cancer-related death among males in the United States, is primarily found in the male reproductive organ.

Aim: To evaluate the role of PSMA PET/CT-derived volumetric quantitative parameters in prostate cancer patient follow-up, assessing their precision and correlation with PSA levels.

Patients and methods: This prospective investigation involved 98 cases with pathologically proven well-differentiated prostate cancer. The study would be conducted in the Nuclear Medicine and Radiation Oncology department from October 2021 to October 2023.

Results: According to TL-PSMA versus SUV max, 27 versus 12 patients were classified as progressive primary neoplasm (p<0.001), 32 versus 19 patients were classified as progressive nodal deposits (p<0.001), 20 versus 22 patients were classified as progressive osseous deposits (p = 0.019), and 6 versus 2 patients were classified as progressive extra-osseous deposits (p = 1). There was statistically insignificant variance among SUV max response and TL-PSMA response in detecting the non-progressed patients with prostate neoplasm (P value 0.415), including sensitivity and specificity of 71% and 72% versus 91% and 84%, respectively. There was statistically insignificant variance among SUV max response and TL-PSMA response in detecting the non-progressed patients with pelvic lymph nodal deposits, osseous deposits, and extra-osseous deposits (P value 0.119, 0.311, 0.620), respectively.

Conclusion: Prostate-specific membrane antigen positron emission tomography is a rapidly growing imaging method for prostate cancer, with potential in various clinical situations, but requires indications and interpretation criteria.