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Diagnostics
Volume 15
Issue 3
10.3390/diagnostics15030301
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer

by
Juan J. Rosales
1,*,
Vicky Betech-Antar
1,
Fernando Mínguez
1,
Edgar F. Guillén
2,
Elena Prieto
3,
Gemma Quincoces
1,
Carmen Beorlegui
4,
María Dolores Fenor de la Maza
5,
Fernando Díez-Caballero
6,
Bernardino Miñana
7,
José Luis Pérez-Gracia
8 and
Macarena Rodríguez-Fraile
1
1
Department of Nuclear Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
2
Department of Nuclear Medicine, Clínica Universidad de Navarra, 28027 Madrid, Spain
3
Department of Medical Physics, Clínica Universidad de Navarra, 31008 Pamplona, Spain
4
Service of Planning, Evaluation and Knowledge Management, Department of Health, Government of Navarra, 31008 Pamplona, Spain
5
Department of Medical Oncology, Clínica Universidad de Navarra, 28027 Madrid, Spain
6
Department of Urology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
7
Department of Urology, Clínica Universidad de Navarra, 28027 Madrid, Spain
8
Department of Medical Oncology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(3), 301; https://doi.org/10.3390/diagnostics15030301
Submission received: 21 December 2024 / Revised: 26 January 2025 / Accepted: 27 January 2025 / Published: 27 January 2025
(This article belongs to the Special Issue Challenges in Urology: From the Diagnosis to the Management)
Review Reports Versions Notes

Abstract

Background/Objectives: The aim of this study was to determine whether semiquantitative and volume-based metrics obtained from [68Ga]Ga-PSMA-11 PET/CT (PSMA-PET) scans before radical prostatectomy (RP) are associated with PSA persistence after surgery in patients with intermediate- (IR) and high-risk (HR) prostate cancer (PCa). Methods: We included 118 consecutive patients (IR = 57; HR = 61) with PCa with a PSMA-PET for initial staging and underwent subsequent RP. Clinical parameters and PSMA-PET metrics in the prostate were obtained to determine the following measurements: SUVmax, SUVmean, Target-to-Background Ratios (TBRs), Prostate Molecular Tumor (pMTV), Prostate Total Lesion Activity (pTLA), Prostate Volume (pV), and Prostate Disease Burden (pDB). The association of PSMA-PET metrics parameters before RP and PSA persistence were analyzed by multivariate logistic regression. Results: SUVmax and volume-based PSMA-PET metrics were significantly higher in patients with ISUP Grade 3–5 vs. ISUP Grade 1–2, and only pMTV, pTLA, and pDB were found to be significantly higher in HR patients, as compared with the IR group. During follow-up, 23 patients showed PSA persistence. pMTV, pTLA, and pDB were significantly higher among patients presenting PSA persistence after RP than in patients with undetectable PSA. Multivariate logistic regression analysis found that lymph node infiltration and pTLA were independent predictors for PSA persistence. A cut-off point of ≥25.1 allowed the best discrimination for PSA persistence (OR: 7.4; IQR: 1.4–39.1; p < 0.05). Conclusions: The identified association between PSA persistence and prostate TLA of PSMA-PET at initial staging highlights its potential as a valuable tool to improve risk prediction in prostate cancer patients. Further research is needed to confirm these results.
Keywords: PSMA-PET; prostate cancer; initial staging; PSA persistence; volume-based metrics PSMA-PET; prostate cancer; initial staging; PSA persistence; volume-based metrics

Share and Cite

MDPI and ACS Style

Rosales, J.J.; Betech-Antar, V.; Mínguez, F.; Guillén, E.F.; Prieto, E.; Quincoces, G.; Beorlegui, C.; Fenor de la Maza, M.D.; Díez-Caballero, F.; Miñana, B.; et al. Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer. Diagnostics 2025, 15, 301. https://doi.org/10.3390/diagnostics15030301

AMA Style

Rosales JJ, Betech-Antar V, Mínguez F, Guillén EF, Prieto E, Quincoces G, Beorlegui C, Fenor de la Maza MD, Díez-Caballero F, Miñana B, et al. Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer. Diagnostics. 2025; 15(3):301. https://doi.org/10.3390/diagnostics15030301

Chicago/Turabian Style

Rosales, Juan J., Vicky Betech-Antar, Fernando Mínguez, Edgar F. Guillén, Elena Prieto, Gemma Quincoces, Carmen Beorlegui, María Dolores Fenor de la Maza, Fernando Díez-Caballero, Bernardino Miñana, and et al. 2025. "Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer" Diagnostics 15, no. 3: 301. https://doi.org/10.3390/diagnostics15030301

APA Style

Rosales, J. J., Betech-Antar, V., Mínguez, F., Guillén, E. F., Prieto, E., Quincoces, G., Beorlegui, C., Fenor de la Maza, M. D., Díez-Caballero, F., Miñana, B., Pérez-Gracia, J. L., & Rodríguez-Fraile, M. (2025). Association of [68Ga]Ga-PSMA-11 PET/CT Metrics with PSA Persistence Following Radical Prostatectomy in Patients with Intermediate- and High-Risk Prostate Cancer. Diagnostics, 15(3), 301. https://doi.org/10.3390/diagnostics15030301

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