PSMA PET/CT correlates with biochemical response in patients with prostate cancer undergoing High-Intensity Focused Ultrasound (HIFU) focal therapy

You have accessJournal of UrologyCME1 Apr 2023MP73-16 SUV VARIATION ON PSMA PET/CT CORRELATES WITH BIOCHEMICAL RESPONSE IN PATIENTS WITH PROSTATE CANCER UNDERGOING HIGH-INTENSITY FOCUSED ULTRASOUND (HIFU) FOCAL THERAPY Egesta Lopci, Giovanni Lughezzani, Vittorio Fasulo, Davide Maffei, Emmanuella Nana Yaa Dede Adjaye, Alberto Saita, Piergiuseppe Colombo, Rodolfo Hurle, Marzo Katia, Roberto Peschechera, Alessio Benetti, Silvia Zandegiacono, Luisa Pasini, Paolo Casale, Luca Balzarini, Arturo Chiti, Giorgio Guazzoni, Nicolò Maria Buffi, and Massimo Lazzeri Egesta LopciEgesta Lopci More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Vittorio FasuloVittorio Fasulo More articles by this author , Davide MaffeiDavide Maffei More articles by this author , Emmanuella Nana Yaa Dede AdjayeEmmanuella Nana Yaa Dede Adjaye More articles by this author , Alberto SaitaAlberto Saita More articles by this author , Piergiuseppe ColomboPiergiuseppe Colombo More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Marzo KatiaMarzo Katia More articles by this author , Roberto PeschecheraRoberto Peschechera More articles by this author , Alessio BenettiAlessio Benetti More articles by this author , Silvia ZandegiaconoSilvia Zandegiacono More articles by this author , Luisa PasiniLuisa Pasini More articles by this author , Paolo CasalePaolo Casale More articles by this author , Luca BalzariniLuca Balzarini More articles by this author , Arturo ChitiArturo Chiti More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , and Massimo LazzeriMassimo Lazzeri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy (FT) for localized prostate cancer (PCa) offers minimally invasive localized ablative treatment while minimizing treatment-related toxicity compared to standard radical options. Recent advances in PCa imaging with PSMA PET/CT offer new opportunities to detect PCa foci and monitor response to treatment. The current study is designed to evaluate the role of PSMA PET/CT for response assessment in PCa patients candidate to High-Intensity Focused Ultrasound (HIFU) focal therapy. METHODS: The present analyses was conducted in patients enrolled in an ongoing, prospective, single-center cohort study of patients treated with HIFU FT for localized PCa. Inclusion criteria: PSA<20 ng/mL, radiological stage≤T2bN0M0, ISUP grade 1-3, PSMA PET/CT at baseline and at response evaluation. Follow up included: PSA at 3, 6 and 12 months; PSMA PET/CT between 6-12 months post treatment. Biochemical response and PET response were statistically correlated: SUVmax and SUVratio to background of the target lesions were used as semi-quantitative parameters for PSMA PET/CT, together with their variations before and after HIFU FT (i.e. ΔSUVmax and ΔSUVratio). RESULTS: Overall, 23 patients met inclusion criteria for the analysis. Median age was 67 years (IQR 63-72), initial PSA (iPSA) was 5.9 ng/mL (IQR 5.2-8.7) and prostate volume was 40 mL (IQR 35.8-50.8). ISUP score was 1 in 16 (70%) patients and 2 in the remaining 7 (30%). Median SUVmax and SUVratio before treatment resulted 3.4 (IQR 2.6-6.3) and 1.4 (IQR 1.1-1.8), respectively. At 3 months post-HIFU, 35% of the patients obtained a PSA response≥50%; whereas at 6 months and 12 months, PSA responses were 35% and 36%, respectively. Median SUVmax and SUVratio post-treatment resulted 2.5 (IQR 1.7-3.4) and 0.9 (IQR 0.7-1.0), respectively, proving a statistically significant reduction compared to baseline values (p=0.048 and 0.0051, respectively). Median ΔSUVmax -22% and ΔSUVratio resulted-30%. There was a statistically significant correlation of ΔSUVmax and PSA response at 12 months post-HIFU (p=0.021) (Figure). CONCLUSIONS: PSMA-PET may be a useful tool for monitoring response in PCa patients undergoing HIFU FT. Moreover, the SUV variation can predict biochemical response at 12 months post-treatment completion. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1041 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Egesta Lopci More articles by this author Giovanni Lughezzani More articles by this author Vittorio Fasulo More articles by this author Davide Maffei More articles by this author Emmanuella Nana Yaa Dede Adjaye More articles by this author Alberto Saita More articles by this author Piergiuseppe Colombo More articles by this author Rodolfo Hurle More articles by this author Marzo Katia More articles by this author Roberto Peschechera More articles by this author Alessio Benetti More articles by this author Silvia Zandegiacono More articles by this author Luisa Pasini More articles by this author Paolo Casale More articles by this author Luca Balzarini More articles by this author Arturo Chiti More articles by this author Giorgio Guazzoni More articles by this author Nicolò Maria Buffi More articles by this author Massimo Lazzeri More articles by this author Expand All Advertisement PDF downloadLoading ...