The value of 68Ga-PSMA-617 PET/CT in differential diagnosis between low-grade and high-grade gliomas

Purpose: PSMA is prostate-specific membrane antigen and abnormally expressed in prostate cancer, subtypes of transitional cell carcinoma, renal cell carcinoma, colon carcinoma and glioblastoma multiforme. Recently, synthesized peptide specific target to PSMA labeled with ⁶⁸Ga have be successfully used in differential diagnosis of recurrent gliomas. The aim of this study was to determine whether ⁶⁸Ga-PSMA-617 PET imaging could be used for differential diagnosis between low-grade and high-grade gliomas.

Methods: 34 gliomas cases confirmed by biopsy or surgery were enrolled, all of them were performed head imaging of ⁶⁸Ga-PSMA-617 PET/CT (Siemens Biograph 40).The mean value of SUV was calculated in both low-grade glioma and high-grade glioma, the difference of SUV value of them was compared by t test. Receiver operating characteristic curve (ROC curve) was made and the cutoff value was defined. Finially, the sensitivity, specific for the differential diagnosis between low grade gliomas and high grade gliomas of ⁶⁸Ga-PSMA-617 PET/CT were calculated.

Results: The average of SUV values were 0.90 ±0.88 and 5.50±3.97 in 15 cases of low-grade gliomas and 19 cases of high-grade gliomas, respectively. There is a significant difference in two groups (t=-4.236, P=0.000). The area under the ROC curve was 0.933 with the cutoff of 2.21 for SUVmax, the sensitivity, specific for the differential diagnosis between low grade gliomas and high grade gliomas were 76.5% and 71.0%.

Conclusions: Preliminary clinical results indicated that the value of SUV of high-grade gliomas is significantly higher than low-grade gliomas by 68Ga-PSMA-617 PET/CT. It can effectively differential the low grade gliomas from high grade gliomas.