Suvmax of the primary prostate lesion on the psma pet ct: an indicator of aggressive pathology

You have accessJournal of UrologyCME1 Apr 2023PD10-04 SUVMAX OF THE PRIMARY PROSTATE LESION ON THE PSMA PET CT: AN INDICATOR OF AGGRESSIVE PATHOLOGY Amandeep Arora, Archi Agarwal, Mahendra Pal, Ganesh Bakshi, Venkatesh Rangarajan, Gujela Ajit, Santosh Menon, and Gagan Prakash Amandeep AroraAmandeep Arora More articles by this author , Archi AgarwalArchi Agarwal More articles by this author , Mahendra PalMahendra Pal More articles by this author , Ganesh BakshiGanesh Bakshi More articles by this author , Venkatesh RangarajanVenkatesh Rangarajan More articles by this author , Gujela AjitGujela Ajit More articles by this author , Santosh MenonSantosh Menon More articles by this author , and Gagan PrakashGagan Prakash More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003250.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PSMA PET CT scans are being increasingly utilized in the staging evaluation of prostate cancer. However, there is limited data regarding the utility of the standardized uptake value (SUVmax) of the primary prostate lesion in the PSMA PET scan. Here, we evaluated whether the SUVmax of the primary prostate lesion can indicate aggressive pathological features in patients undergoing radical prostatectomy (RP) with an extended pelvic nodal dissection (PLND). METHODS: We retrospectively reviewed a prospectively maintained institutional database for prostate cancer patients from 2015-2022 who had a PSMA PET scan for their staging evaluation followed by a RP with PLND. Data was collected for clinico-pathological variables. The SUVmax of the primary lesion in the prostate was noted & compared across the pathological Gleason grade groups (GGG). We also checked whether the SUVmax had an association with Gleason upgrading & pathological nodal status. RESULTS: A total of 205 patients were included & were stratified into the following clinical risk groups based on MRI & PSMA-PET scans: 6 (2.9%) low-risk, 49 (23.9%) intermediate-risk, 46 (22.4%) high-risk localized, 89 (43.4%) locally-advanced node-negative & 15 (7.3%) node-positive patients. The median SUVmax of the primary prostate lesion for pathological GGG 1, 2, 3, 4 & 5 were 6.45, 11.3, 18.11, 25.51 & 24.37 respectively (p<0.001). For the 153 patients with a Gleason score 6-7 on transrectal biopsy, 19 patients had an upgrading of their score to >8 on the final pathology. The median SUV max of the prostate lesion in these 19 patients was significantly higher [median 22.37 (IQR 15.5–33.1)] than that in the remaining 134 patients with biopsy Gleason score 6-7 who did not have an upgrading to >8 on the final pathology [median 11.3 (IQR 7.4–17.5)]; p<0.001 (Figure 1). Also, the median SUVmax of the primary prostate lesion in patients who were true negatives for nodes, as per the PSMA-PET scan & final pathology, was significantly lower (12.8 vs 26.4, p<0.001) than that in patients who were false negative (cN0 on PSMA but pN+ in final pathology). CONCLUSIONS: Higher SUVmax of the primary prostate lesion is an indicator of aggressive pathological behaviour in the form of Gleason upgrading positive pelvic nodal status. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e327 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amandeep Arora More articles by this author Archi Agarwal More articles by this author Mahendra Pal More articles by this author Ganesh Bakshi More articles by this author Venkatesh Rangarajan More articles by this author Gujela Ajit More articles by this author Santosh Menon More articles by this author Gagan Prakash More articles by this author Expand All Advertisement PDF downloadLoading ...