Article Figures & Data
Figures
- FIGURE 1.
CONSORT (Consolidated Standards of Reporting Trials) diagram. AR = androgen receptor; 5α- = 5α-reductase.
- FIGURE 2.
Violin plots of significantly different exemplary PSMA uptake levels of normal organs according to ADT treatment status. White dots indicate median value. No = control; Yes = ADT.
- FIGURE 3.
Violin plots of PSMA uptake levels of normal organs in ADT group according to different ADT runtimes and control group. Only significant values after post hoc testing are displayed as bars on figures. Nonsignificant P values are displayed in figure heading. White dots indicate median values.
- FIGURE 4.
Violin plots of PSMA uptake levels according to prior cytotoxic treatments (177Lu-PSMA RLT or chemotherapy) in normal organs. White dots indicate median value. Yes = prior systemic therapies; No = no prior systemic therapy.
Tables
Variable Control (n = 56) ADT (n = 56) P Age (y) 69.6 (±7.2) 70.4 (±8.0) 0.58 Weight (kg) 86.2 (±12.6) 83.4 (±13.6) 0.31 Tracer dose (MBq) 181.8 (±18.1) 183.4 (±19.4) 0.59 PSA (μg/dL)* 13.0 (±46.1) 7.1 (±12.6) 0.06 GFR (mL/min)† 78.4 (±15.5) 81.0 (±14.2) 0.39 MTV (cm3) 3.3 (±5.3) 5.0 (±6.2) 0.20 PSMA-positive lesions Prostate 21 (37.5%) 21 (37.5%) >0.99 Lymph nodes 19 (33.9%) 14 (25.0%) 0.41 Bone 8 (14.3%) 18 (32.1%) 0.04 Viscera (lung) 2 (3.6%) 1 (1.8%) >0.99 Mean lesional SUVmean Prostate 13.1 (±11.4) 10.8 (±8.4) 0.43 Lymph nodes 7.5 (±4.3) 10.39 (±6.3) 0.13 Bone 4.9 (±2.2) 9.4 (±12.5) 0.84 Viscera (lung) 4.79 (4.0–5.6) 7.7 —‡ Mean ADT runtime (m) — 24.0 ± 34.9 Runtimes binned (m) 1–6 — 15 (26.8%) >6 — 41 (73.2%) ADT drug class GnRH analog Leuprorelin — 38 (67.9%) Triptorelin — 2 (3.6%) GnRH antagonist Degarelix — 16 (28.6%) Previous cytotoxic treatments 20 (35.7%) CHT — 19 (33.9%) 177Lu-PSMA — 3 (5.3%) ↵* Missing data for control (n = 8) and ADT group (n = 4).
↵† Missing data for control (n = 9) and ADT group (n = 8).
↵‡ Statistical testing not feasible because of sample size in control group (n = 2; data as mean and range) and ADT group (n = 1).
PSA = prostate-specific antigen; GFR = glomerular filtration rate; GnRH = gonadotropin-releasing hormone; CHT = chemotherapy.
Qualitative data are number and percentages; continuous data are mean and SD.
Variable Control (n = 56) ADT (n = 56) Difference P Kidney SUVmean*† 29.5 ± 7.2; 95% CI, 27.57–31.42; range, 16.59–52.12 21.61 ± 8.1; 95% CI, 19.44–23.78; range, 5.18–37.36 Δyes − no = −7.89; 95% CI, −10.73 to −5.04 <0.001 Kidney SUVpeak* 54.76 ± 14.29; 95% CI, 50.94–58.59; range, 26.65–93.75 40.64 ± 16.49; 95% CI, 36.23–45.06; range, 6.82–77.99 Δyes − no = −14.12; 95% CI, −19.85 to −8.39 <0.001 Liver SUVmean‡ 4.8 ± 1.31; 95% CI, 4.45–5.15; range, 2.15–8.63 4.44 ± 1.65; 95% CI, 3.99–4.88; range, 0.92–10.39 ΔADT − control = −0.14; 95% CI, −0.86 to 0.10 0.12 Liver SUVpeak‡ 18.06 ± 14.75; 95% CI, 14.11–22.01; range, 3.81–55.8 11.18 ± 8.97; 95% CI, 8.78–13.58; range, 1.19–37.64 ΔADT − control = −2.3; 95% CI, −5.72 to −0.93 0.003 Spleen SUVmean‡ 6.08 ± 2.04; 95% CI, 5.53–6.62; range, 2.55–11.59 5.86 ± 2.42; 95% CI, 5.21–6.51; range, 0.782–14.56 Δyes − no = −0.49; 95% CI, −1.5 to 0.99 0.46 Spleen SUVpeak‡ 14.76 ± 11.15; 95% CI, 11.78–17.75; range, 4.81–53.79 11.56 ± 9.61; 95% CI, 8.99–14.13; range, 1.14–52.34 ΔADT − control = −1.27; 95% CI, −3.61 to −0.16 0.033 Salivary gland SUVmean‡§ 11.34 ± 2.69; 95% CI, 10.62–12.06; range, 4.41–17.05 9.93 ± 3.17; 95% CI, 9.07–10.8; range, 1.18–18.02 ΔADT − control = −1.04; 95% CI, −2.48 to −0.13 0.027 Salivary gland SUVpeak* 20.0 ± 5.02; 95% CI, 18.65–21.34; range, 7.53–34.76 16.69 ± 5.61; 95% CI, 15.16–18.22; range, 1.7–30.42 ΔADT − control = −3.31; 95% CI, −5.3 to −1.31 0.001 - TABLE 3.
Multivariate Regression Analysis of Relationship Between Renal, Hepatic, Splenic, and Salivary Gland PSMA Uptake and Explanatory Variables MTV, Glomerular Filtration Rate, and ADT Status
Predicted endpoint Variable Odds ratio P Kidney SUVmean Intercept 17.78; 9.28 to 26.27 <0.0001 MTV (cm3) −0.218; −0.495 to 0.0585 0.121 GFR (mL/min) 0.156; 0.0531 to 0.259 0.0034 ADT (0 = no, 1 = yes) −7.95; −11.06 to −4.84 <0.0001 Liver SUVpeak Intercept 10.94; −1.06 to 22.94 0.0735 MTV (cm3) 0.0389; −0.301 to 0.379 0.821 GFR (mL/min) 0.09; −0.0606 to 0.241 0.238 ADT (0 = no, 1 = yes) −7.85; −11.78 to −3.91 <0.0001 Spleen SUVpeak Intercept 6.36; −5.73 to 18.45 0.299 MTV (cm3) 0.295; −0.114 to 0.704 0.156 GFR (mL/min) 0.104; −0.0615 to 0.27 0.214 ADT (0 = no, 1 = yes) −5.83; −9.95 to −1.7 0.006 SM SUVmean Intercept 12.2; 8.67 to 15.73 <0.0001 MTV (cm3) −0.0679; −0.183 to 0.0472 0.244 GFR (mL/min) −0.00771; −0.0506 to 0.0352 0.722 ADT (0 = no, 1 = yes) −1.47; −2.76 to −0.167 0.0274 GFR = glomerular filtration rate; SM = Submandibular gland.
Odds ratio is followed by 95% CI.
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