PD19-12 THE ROLE OF PSMA PET/CT IN PREDICTING PATHOLOGICAL LOCAL STAGING AND GRADING FOR PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (PD19)1 May 2024PD19-12 THE ROLE OF PSMA PET/CT IN PREDICTING PATHOLOGICAL LOCAL STAGING AND GRADING FOR PROSTATE CANCER Andrea Piccolini, Giuseppe Chiarelli, Paola Arena, Vittorio Fasulo, Filippo Dagnino, Nicola Frego, Paolo Casale, Alberto Saita, Massimo Lazzeri, Rodolfo Hurle, Nicolò Buffi, Fabrizia Gelardi, Jelena Jandric, Lorenzo Muraglia, Marcello Rodari, Laura Evangelista, and Giovanni Lughezzani Andrea PiccoliniAndrea Piccolini , Giuseppe ChiarelliGiuseppe Chiarelli , Paola ArenaPaola Arena , Vittorio FasuloVittorio Fasulo , Filippo DagninoFilippo Dagnino , Nicola FregoNicola Frego , Paolo CasalePaolo Casale , Alberto SaitaAlberto Saita , Massimo LazzeriMassimo Lazzeri , Rodolfo HurleRodolfo Hurle , Nicolò BuffiNicolò Buffi , Fabrizia GelardiFabrizia Gelardi , Jelena JandricJelena Jandric , Lorenzo MuragliaLorenzo Muraglia , Marcello RodariMarcello Rodari , Laura EvangelistaLaura Evangelista , and Giovanni LughezzaniGiovanni Lughezzani View All Author Informationhttps://doi.org/10.1097/01.JU.0001009448.41537.64.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PSMA PET/CT has emerged as the gold standard in clinical practice for whole-body re-staging of intermediate to high-risk prostate cancer (PCa). Its application in primary diagnosis has also been suggested. Our aim was to investigate PSMA PET/CT performance in predicting local staging and pathological grading prior to radical surgery, with the endpoint of tailoring the surgical approach according to disease characteristics. METHODS: We retrospectively reviewed prospectively collected data of patients referred to our tertiary-care center from October 2020 to June 2023. We selected patients who underwent primary staging PSMA PET/CT before undergoing robot-assisted radical prostatectomy (RARP), with or without lymph node dissection (LND). Among these patients, 112 (47%) received 68Ga-PSMA-11, while 126 (53%) 18F-PSMA-1007. We assessed the Standard Uptake Value max of the primary tumor (SUV max) and the tumor-to-background ratio (SUV ratio) and examined their relationship with pathological tumor staging (pT) and International Society for Urological Pathology grading (ISUP). The Cochran-Armitage test for trend was utilized to analyze the association between SUV values and PCa stage and grade. RESULTS: Overall, 239 patients were included, with a median age of 66 years (IQR 60-71). 55 (23%) patients had PCa family history. Median PSA was 7.3 (5.6-12.5) ng/ml. According to European Association of Urology risk groups, 140 (59%) were low/intermediate risk and 99 (41%) high risk. LND was performed in 193 (81%) patients. Median SUV max and SUV ratio significantly increased from 5.64 (4.28-10.8) and 11 (7-21) in pT2a to 12.5 (7.4-19.8) and 23 (12.8-50) in pT3b patients, respectively (all p<0.001). Median SUV max and SUV ratio increased from 5.99 (5.29-6.69) and 9 (4-14) in ISUP 1 PCa to 12.81 (5.94-21.79) and 28 (17-51) in ISUP 5 PCa, respectively (all p<0.001). Similarly median SUV max and SUV ratio increased from 6.09 (4.09-11.85) and 12.5 (8-24) in organ confined disease to 13.18 (6.75-19.31) and 23 (12-49) in non-organ confined disease, respectively (all p<0.001). CONCLUSIONS: According to our findings, both SUV max and SUV ratio values were significantly associated with tumor staging and ISUP grading. Consequently, PSMA PET/CT holds promise as a valuable tool for pre-treatment risk stratification in PCa patients, potentially playing a crucial role in guiding treatment decisions for these individuals. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e445 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrea Piccolini More articles by this author Giuseppe Chiarelli More articles by this author Paola Arena More articles by this author Vittorio Fasulo More articles by this author Filippo Dagnino More articles by this author Nicola Frego More articles by this author Paolo Casale More articles by this author Alberto Saita More articles by this author Massimo Lazzeri More articles by this author Rodolfo Hurle More articles by this author Nicolò Buffi More articles by this author Fabrizia Gelardi More articles by this author Jelena Jandric More articles by this author Lorenzo Muraglia More articles by this author Marcello Rodari More articles by this author Laura Evangelista More articles by this author Giovanni Lughezzani More articles by this author Expand All Advertisement PDF downloadLoading ...