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Research ArticleTheranostics

68Ga-PSMA-11 PET/CT in Newly Diagnosed Carcinoma of the Prostate: Correlation of Intraprostatic PSMA Uptake with Several Clinical Parameters

Stefan A. Koerber, Maximilian T. Utzinger, Clemens Kratochwil, Claudia Kesch, Matthias F. Haefner, Sonja Katayama, Walter Mier, Andrei H. Iagaru, Klaus Herfarth, Uwe Haberkorn, Juergen Debus and Frederik L. Giesel
Journal of Nuclear Medicine December 2017, 58 (12) 1943-1948; DOI: https://doi.org/10.2967/jnumed.117.190314
Stefan A. Koerber
1Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
2Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
3National Center of Radiation Oncology (NCRO), Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
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Maximilian T. Utzinger
4Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Clemens Kratochwil
4Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
5Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Claudia Kesch
6Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
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Matthias F. Haefner
1Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
2Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
3National Center of Radiation Oncology (NCRO), Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
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Sonja Katayama
1Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
2Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
3National Center of Radiation Oncology (NCRO), Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
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Walter Mier
4Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Andrei H. Iagaru
7Division of Nuclear Medicine and Molecular Imaging, Stanford Health Care, Stanford, California; and
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Klaus Herfarth
1Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
2Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
3National Center of Radiation Oncology (NCRO), Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
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Uwe Haberkorn
4Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
5Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Juergen Debus
1Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
2Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
3National Center of Radiation Oncology (NCRO), Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
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Frederik L. Giesel
4Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
5Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
8German Cancer Consortium (DKTK), Heidelberg, Germany
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  • Article
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Article Figures & Data

Figures

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  • FIGURE 1.
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    FIGURE 1.

    Box plot of SUVmax from malignant (left) and normal (right) intraprostatic tissue.

  • FIGURE 2.
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    FIGURE 2.

    Box plot of SUVmax according to GS in biopsy (A) and d’Amico classification (B).

  • FIGURE 3.
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    FIGURE 3.

    Box plot of SUVmax according to ungrouped GS in biopsy (A) and to International Society of Urologic Pathologists (ISUP) grade in biopsy (B).

  • FIGURE 4.
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    FIGURE 4.

    Box plot of SUVmax of GS (grouped) after prostatectomy.

  • FIGURE 5.
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    FIGURE 5.

    Different PSMA tracer uptake according to GS: 1 patient with GS 6 prostate cancer and SUVmax of 7.33 (A) compared with a GS 9 tumor and SUVmax of 16.64 (B).

  • FIGURE 6.
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    FIGURE 6.

    Relevant data for intraprostatic boost during radiotherapy: MRI of prostate with apparent diffusion coefficient sequence (A), PSMA tracer uptake in PSMA PET/CT (B), and radiation plan with irradiation of prostate and simultaneous integrated boost according to pretreatment imaging (C).

Tables

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    TABLE 1

    Patient Characteristics

    CharacteristicAll patients (n = 104)
    Median age (y)67.4 (range, 38–84)
    Clinical tumor stage
     T1a—
     T1b—
     T1c39
     T2a1
     T2b1
     T2c25
     T3a7
     T3b26
     T45
     N072
     N132
     M082
     M1a3
     M1b17
     M1c2
    GS (biopsy)
     615
     7a24
     7b16
     819
     926
     104
    Current PSA
     <10 ng/mL35
     10–20 ng/mL30
     >20 ng/mL38
     Unknown1
    d’Amico score (21)
     Low risk6
     Intermediate risk17
     High risk81
    • View popup
    TABLE 2

    Comparison of SUVmax and Clinical Parameters

    Clinical parameterMedianMean SUVmaxSDP
    Current PSA (n = 103)<0.001
     105.988.555.88
     10–207.9414.9716.20
     2014.7719.4715.47
    GS in biopsy (grouped; n = 104)<0.001
     6–76.289.8810.49
     8–1016.2919.6115.44
    GS in biopsy (n = 104)<0.001
     64.626.746.10
     7a5.569.7413.47
     7b11.5613.047.89
     813.9416.410.75
     916.9922.1618.46
     1016.8818.3012.45
    d’Amico score (n = 104)
     Grouped<0.001
      Low/intermediate risk5.796.723.95
      High risk12.2716.6714.88
     Ungrouped<0.001
      Low risk5.125.973.69
      Intermediate risk5.796.984.11
      High risk12.2716.6714.88
    • View popup
    TABLE 3

    Comparison of SUVmax and GS in MR-Guided Biopsy and Prostatectomy

    GSMedianMean SUVmaxSDP
    In MR-guided biopsy (grouped; n = 50)0.004
     77.5911.2412.9
     8–1013.1219.4517.24
    After prostatectomy (grouped; n = 28)0.14
     78.3214.111.07
     8–1016.6420.4111.51
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Journal of Nuclear Medicine: 58 (12)
Journal of Nuclear Medicine
Vol. 58, Issue 12
December 1, 2017
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68Ga-PSMA-11 PET/CT in Newly Diagnosed Carcinoma of the Prostate: Correlation of Intraprostatic PSMA Uptake with Several Clinical Parameters
Stefan A. Koerber, Maximilian T. Utzinger, Clemens Kratochwil, Claudia Kesch, Matthias F. Haefner, Sonja Katayama, Walter Mier, Andrei H. Iagaru, Klaus Herfarth, Uwe Haberkorn, Juergen Debus, Frederik L. Giesel
Journal of Nuclear Medicine Dec 2017, 58 (12) 1943-1948; DOI: 10.2967/jnumed.117.190314

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68Ga-PSMA-11 PET/CT in Newly Diagnosed Carcinoma of the Prostate: Correlation of Intraprostatic PSMA Uptake with Several Clinical Parameters
Stefan A. Koerber, Maximilian T. Utzinger, Clemens Kratochwil, Claudia Kesch, Matthias F. Haefner, Sonja Katayama, Walter Mier, Andrei H. Iagaru, Klaus Herfarth, Uwe Haberkorn, Juergen Debus, Frederik L. Giesel
Journal of Nuclear Medicine Dec 2017, 58 (12) 1943-1948; DOI: 10.2967/jnumed.117.190314
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