RT Journal Article
SR Electronic
T1 PSMA PET for the Assessment of Metastatic Hormone-Sensitive Prostate Cancer Volume of Disease
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1747
OP 1750
DO 10.2967/jnumed.121.262120
VO 62
IS 12
A1 Francesco Barbato
A1 Wolfgang P. Fendler
A1 Isabel Rauscher
A1 Ken Herrmann
A1 Axel Wetter
A1 Justin Ferdinandus
A1 Robert Seifert
A1 Michael Nader
A1 Kambiz Rahbar
A1 Boris Hadaschik
A1 Matthias Eiber
A1 Andrei Gafita
A1 Manuel Weber
YR 2021
UL http://jnm.snmjournals.org/content/62/12/1747.abstract
AB Conventional imaging of low-volume disease (LVD) versus high-volume disease (HVD) is associated with survival in metastatic hormone-sensitive prostate cancer (mHSPC) according to the CHAARTED trial (Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer) and the STAMPEDE trial (Systemic Therapy for Advanced or Metastatic Prostate Cancer: Evaluation of Drug Efficacy). We propose a compatible quantitative PSMA PET framework for disease volume assessment in mHSPC. Methods: Three PET centers screened their PSMA PET database for mHSPC patients. CT versus PSMA PET stage, lesion number, and classification of LVD versus HVD were determined by 1 masked reader; PSMA-positive tumor volume was quantified semiautomatically. Results: In total, 85 CT-based CHAARTED LVD and 20 CT-based CHAARTED HVD patients were included. A PSMA tumor volume of about 40 cm3 was the optimal cutoff between CT-based CHAARTED LVD (nonunifocal) and HVD (non-M1c) (area under the curve, 0.86). Stratification into PET LVD (unifocal or oligometastatic/disseminated < ∼40 cm3) and PET HVD (oligometastatic/disseminated ≥ ∼40 cm3 or M1c) had 13% misalignment with the CHAARTED criteria. Conclusion: PSMA PET criteria with volume quantification deliver comparable LVD/HVD discrimination with additional subgroups for unifocal, oligometastatic, and disseminated disease, critical for guidance of targeted or multimodal therapy.