Article Figures & Data
Figures
- FIGURE 1.
Study flow for 68Ga-PSMA PET/CT primary staging of high-risk PCa patients.
- FIGURE 2.
(A) Correlation between SUVmax of primary tumors and ISUP grade from transrectal ultrasound–guided or MRI-guided biopsy. Data are median. (B) Correlation between SUVmax of primary tumors and RP ISUP grade. Data are median. (C) Primary tumor SUVmax in correlation with advanced disease (N1/M1). Data are median. (D) Correlation between SUVmax of primary tumors and PSA at diagnosis. Data are line of best fit with 95% CI. *Radical prostatectomy.
- FIGURE 3.
Occurrence of advanced disease (N1/M1) (A), LNMs (N1/M1a) (B), and BMs (M1b) (C) according to PSA interval.
- FIGURE 4.
Incidence of advanced disease (N1/M1) (A), LNMs (N1/M1a) (B), and BMs (M1b) (C) according to ISUP grade.
- FIGURE 5.
Presence of advanced disease (N1/M1) according to clinical stage.
- FIGURE 6.
(A) Primary prostate tumors. From left: 68Ga-PSMA PET/CT (arrow), PSMA-positive immunohistochemical staining of primary tumor from previous image, PSMA-negative immunohistochemical staining of primary tumor, and PSMA-positive immunohistochemical staining of primary tumor. (B) LNMs from corresponding primary tumors in A. From left: LNMs on 68Ga-PSMA PET/CT (arrow), PSMA-positive immunohistochemical staining of true-positive LNMs from previous image, PSMA-negative immunohistochemical staining of undetected LNMs, and PSMA-positive immunohistochemical staining of undetected LN micrometastasis, characteristically located in the border of the LN cortex.
Tables
- TABLE 1
Study Group Characteristics and Odds Ratios (ORs) for Having Advanced Disease Compared with Reference
Characteristic Study group (n = 691) Advanced disease on 68Ga-PSMA PET/CT Univariate ORs of advanced disease Multivariate ORs of advanced disease Age (y) Median 70.4 Range 45.2–87.2 Time from biopsy to scan (mo) Median 0.7 Range 0.1–5.1 Prescan PSA (ng/mL) <10 200 (28.9%) 37 (18.5%) Reference = 1 Reference = 1 10–20 194 (28.1%) 58 (29.9%) OR1 = 1.88 (1.17, 3.01) OR1 = 1.45 (0.86, 2.47) >20 297 (43.0%) 149 (50.2%) OR2 = 4.44 (2.90, 6.77) OR2 = 4.32 (2.66, 7.12) Unknown 0 (0.0%) ISUP grade in biopsies 1 41 (5.9%) 1 (2.4%) Reference = 1 Reference = 1 2 102 (14.8%) 11 (10.8%) OR1 = 4.84 (0.89, 89.87) OR1 = 3.75 (0.67, 70.51) 3 89 (12.9%) 33 (37.1%) OR2 = 23.57 (4.76, 427.76) OR2 = 19.67 (3.84, 361.15) 4 262 (38.0%) 81 (30.9%) OR3 = 17.90 (3.79, 320.27) OR3 = 25.55 (5.21, 462.70) 5 196 (28.4%) 117 (59.7%) OR4 = 59.24 (12.47, 1061.62) OR4 = 53.17 (10.79, 964.19) Unknown 1 (0.1%) Clinical stage* cT1 123 (17.8%) 13 (10.6%) Reference = 1 Reference = 1 cT2 246 (35.6%) 60 (24.4%) OR1 = 2.73 (1.47, 5.40) OR1 = 2.18 (1.13, 4.45) cT3 314 (45.4%) 165 (52.5%) OR2 = 9.37 (5.23, 18.11) OR2 = 7.13 (3.80, 14.29) cT4 8 (1.2%) 6 (75.0%) OR3 = 25.38 (5.25, 186.23) OR3 = 17.26 (2.82, 160.69) Unknown 0 (0.0%) ↵* Digital rectal examination.
Qualitative data are numbers followed by percentages in parentheses; continuous data are OR followed by 95% CI in parentheses.
Parameter SUVmax in primary tumors ISUP grade in biopsies 1 (n = 41) 13.07 (10.48, 16.31) 2 (n = 102) 15.36 (13.59, 17.36) 3 (n = 89) 22.86 (20.04, 26.07) 4 (n = 262) 16.58 (15.20, 18.08) 5 (n = 196) 24.31 (22.09, 26.75) ISUP grade in RP specimens 1 (n = 10) 9.79 (6.33, 15.15) 2 (n = 96) 10.57 (9.38, 11.92) 3 (n = 60) 17.60 (14.84, 20.87) 4 (n = 47) 16.65 (13.72, 20.20) 5 (n = 34) 19.87 (16.62, 23.75) Advanced disease No (n = 447) 15.86 (14.87, 16.91) Yes (n = 244) 25.75 (23.76, 27.91) Data are median followed by 95% CI in parentheses.
Lesion site Lesions measured (n) Median SUVmax Primary tumor 691 19.5 (range, 3.1–140.5) LNs (regional and nonregional) 1,222 21.1 (range, 2.2–136.3) BMs 386 17.3 (range, 1.8–137.9) Visceral metastases 40 8.1 (range, 3.2–48.0) - TABLE 4
Histopathologic Coherence Between PSMA-Positive or -Negative LNs and Pathologic Verification in Patients with PLND
Histology (n = 177) 68Ga-PSMA PET/CT Positive (n = 36) Negative (n = 141) Index Positive (n = 16) n = 11 (30.6%) n = 5 (3.5%) PPV 68.8% Negative (n = 161) n = 25 (69.4%) n = 136 (96.5%) NPV 84.5% Index Sensitivity 30.6% Specificity 96.5% Accuracy 83.1% PPV and NPV = positive and negative predictive values, respectively.
