Purpose

Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) targeting tracers has emerged as a valuable diagnostic tool for prostate cancer (PCa), androgen deprivation therapy (ADT) stands as the cornerstone treatment for advanced PCa, yet forecasting the response to hormonal therapy poses a significant clinical hurdle.

Methods

In a prospective cohort of 86 PCa patients undergoing short-term ADT, this study evaluated the prognostic potential of [18F]DCFPyL PET/CT scans. Comprehensive data encompassing clinical profiles, baseline prostate-specific antigen (PSA) levels, and imaging metrics were assessed. We developed predictive models for assessing decreases in PSA levels (PSA50 and PSA70) based on a combination of PET-related parameters and clinical factors. Kaplan-Meier survival analysis was utilized to ascertain the prognostic value of PET-based metrics.

Results

In this study, elevated [18F]DCFPyL uptake within the primary tumor, as indicated by a SUV ≥ 6.78 (p = 0.0024), and a reduction in the tumor volume (TV) of primary PSMA-avid tumor with PSMA-TV < 41.96 cm³ (p = 0.038), as well as an increased burden of metastatic PSMA-avid tumor, with PSMA-TV (PSMA-TV ≥ 71.39 cm³) (p = 0.012) were identified in association with diminished progression-free survival (PFS). PET and clinical parameters demonstrated constrained predictive capacity for PSA50 response as indicated by an area under the curve (AUC) of 0.442.

Conclusion

Our study revealed that pretreatment [18F]DCFPyL uptake in primary or metastatic tumor sites is prognostically relevant in high-risk PCa patients undergoing ADT.

Further research is needed to develop robust predictive models in this multifaceted landscape of PCa management.

中文翻译：

---

初治前列腺癌中的初始 [18F]DCFPyL PET/CT：与 ADT 后 PSA 结果和复发的相关性

目的

带有前列腺特异性膜抗原 (PSMA) 靶向示踪剂的正电子发射断层扫描 (PET) 已成为前列腺癌 (PCa) 的有价值的诊断工具，雄激素剥夺疗法 (ADT) 是晚期 PCa 的基石治疗，但可预测反应激素治疗构成了重大的临床障碍。

方法

在一项由 86 名接受短期 ADT 的 PCa 患者组成的前瞻性队列中，本研究评估了 [18F]DCFPyL PET/CT 扫描的预后潜力。评估了包括临床概况、基线前列腺特异性抗原（PSA）水平和成像指标在内的综合数据。我们根据 PET 相关参数和临床因素的组合开发了用于评估 PSA 水平（PSA50 和 PSA70）下降的预测模型。 Kaplan-Meier 生存分析用于确定基于 PET 的指标的预后价值。

结果

在本研究中，原发肿瘤内的 [18F]DCFPyL 摄取升高，如 SUV ≥ 6.78 ( p = 0.0024) 所示，并且原发性 PSMA 亲和肿瘤的肿瘤体积 (TV) 减少，PSMA-TV < 41.96 cm ³ ( p = 0.038) 以及 PSMA-TV (PSMA-TV ≥ 71.39 cm ³ ) ( p = 0.012) 转移性 PSMA 亲和肿瘤负担增加与无进展生存期缩短相关 (无进展生存期）。 PET 和临床参数表明 PSA50 反应的预测能力有限，曲线下面积 (AUC) 为 0.442。

结论

我们的研究表明，治疗前原发性或转移性肿瘤部位的 [18F]DCFPyL 摄取与接受 ADT 的高危 PCa 患者的预后相关。

需要进一步研究以在 PCa 管理的多方面领域开发稳健的预测模型。