The added value of <sup>18</sup>F-FDG PET/CT compared to <sup>68</sup>Ga-PSMA PET/CT in patients with castration-resistant prostate cancer.
Where this comes from
- Record sourced from PubMed, PMID 33893190.
- Also identified by DOI 10.2967/jnumed.121.262250.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
<b>Purpose:</b> The <sup>68</sup>Ga-PSMA PET/CT is a commonly used imaging modality in prostate cancers. However, few studies have compared the diagnostic efficiency between <sup>68</sup>Ga-PSMA and <sup>18</sup>F-FDG PET/CT and evaluated whether a heterogeneous metabolic phenotype (especially PSMA-FDG+ lesions) exists in patients with castration-resistant prostate cancer (CRPC). We determined the added value of <sup>18</sup>F-FDG PET/CT compared to <sup>68</sup>Ga-PSMA PET/CT in CRPC patients and identified CRPC patients who may benefit from additional <sup>18</sup>F-FDG PET/CT. <b>Methods:</b> Data of 56 patients with CRPC who underwent both <sup>68</sup>Ga-PSMA and <sup>18</sup>F-FDG PET/CT from May 2018 to February 2021 were retrospectively analysed. Patients were classified into two groups with or without PSMA-FDG+ lesions. The differences in patient characteristics between the two groups and predictors of patients who having at least one PSMA-FDG+ lesion were analysed. <b>Results:</b> Although both the detection rate (75.0% vs. 51.8%, <i>P</i> = 0.004) and positive lesion number (135 vs. 95) of <sup>68</sup>Ga-PSMA PET/CT were higher than <sup>18</sup>F-FDG PET/CT, there were still 13/56 (23.2%) patients with at least one PSMA-FDG+ lesion. The prostate-specific antigen (PSA) and Gleason score were both higher in the patients with PSMA-FDG+ lesions than in those without PSMA-FDG+ lesions (<i>P</i> = 0.04 and P<0.001, respectively). Multivariate regression analysis showed that the Gleason score (≥8) and PSA (≥7.9 ng/mL) were associated with the detection rate of patients who had PSMA-FDG+ lesions (<i>P</i> = 0.01 and <i>P</i> = 0.04, respectively). The incidences of having PSMA-FDG+ lesions in low-probability (Gleason score<8 and PSA<7.9 ng/mL), medium-probability (Gleason score≥8 and PSA<7.9 ng/mL or Gleason score<8 and PSA≥7.9 ng/mL), and high-probability (Gleason score≥8 and PSA≥7.9 ng/mL) groups were 0%, 21.7%, and 61.5%, respectively (P<0.001). <b>Conclusion:</b> Gleason score and PSA are significant predictors for PSMA-FDG+ lesions, and CRPC patients with high Gleason score and PSA may benefit from additional <sup>18</sup>F-FDG PET/CT.