THE RELATIONSHIP BETWEEN LABORATORY/PATHOLOGY RESULTS AND GA-68 PSMA PET/CT FINDINGS IN PATIENTS WITH PROSTATE CANCER

Year 2020, , 231 - 242, 19.01.2021

Burak Sönmezer Emine Acar Pembe Keskinoğlu Erkan Derebek

https://doi.org/10.5505/deutfd.2020.93899

Abstract

Objective: To compare imaging results and pathology, laboratory results and to analyze the relationship between them in patients who were performed PSMA PET/CT due to prostate cancer.
Materials and Methods: 123 patients who were performed PSMAPET/CT for “staging” and “re-staging” were analyzed retrospectively. SUVmax values were measured for prostate, lymph node, bone and visceral organs. The correlation between these values and Gleason score/grade and laboratory results were evaluated. The differences between the patients who were detected and not detected to have pathological findings on PET/CT were evaluated with regard to pathology and laboratory results.
Results: A significant difference was detected between the patients who were detected and not detected to have bone involvement on PET/CT with regard to ALP and Ca values (p=0.010, p=0.003, respectively). A very weak correlation was detected between the highest SUVmax and LDH (r=0.19). There was a significant difference between the patients with and without peri-neural invasion with regard to maximum SUVmax (p=0.012). In staging group, a moderate correlation was detected between prostate SUVmax, the highest SUVmax and GG and PSA (r=0.42, r=0.5, r=0.54, r=0.53, respectively). A significant difference was detected between the patients whose GG was ≤2 and GG>2 with regard to prostate SUVmax and the highest SUVmax (p=0.005, p=0.002; respectively). There was a significant difference between the patients whose PSA was ≤20 and >20 ng/ml with regard to prostate SUVmax (p=0.045). PSA, GS, GG showed significant differences between the patients who were negative and positive on PET/CT (p<0.001, p= 0.032, p=0.030; respectively).
Conclusion: Results of the study suggest that PSMAPET/CT should routinely be used for staging in intermediate-high risk patients and for re-staging in patients who are suspected to have recurrence or who have biochemical recurrence

Prostat kanserli hastalarda laboratuvar/patoloji bulguları ile Ga-68 PSMA PET/BT bulgularının ilişkisi

Abstract

Amaç: Prostat kanseri nedeniyle Ga-68 PSMA PET/BT görüntülemesi yapılan hastaların görüntülemelerinde saptanan bulguları; patoloji, laboratuvar bulguları ile karşılaştırmaktır.
Gereç ve Yöntem: “Evreleme" ve “yeniden evreleme” amaçlı PSMA PET/BT görüntülemesi yapılan 123 hasta retrospektif olarak incelendi. Tüm hastaların prostat, lenf nodu, kemik, visseral organ ve en yüksek SUVmax değerleri ölçüldü. Bu değerler ile “Gleason Skoru”, “Gleason Grade” ve laboratuvar bulguları arasındaki korelasyon değerlendirildi. PSMA PET/BT’de patolojik bulgu saptanmayan hastalar ile saptananlar arasında patoloji ve laboratuvar bulguları arasındaki farklılıklar incelendi.
Bulgular: Tüm grupta PSMA PET/BT’de kemik tutulumu saptanmayan hastalar ile saptananlar arasında ALP ve Ca değerleri anlamlı farklılık göstermektedir(sırasıyla p: 0,010,p: 0,003). En yüksek SUVmax değerleri ile LDH değerleri arasında çok zayıf korelasyon saptanmıştır (r=0,19). Perinöral invazyonu olmayan hastalar ile olan hastaların en yüksek SUVmax değerleri anlamlı farklılık göstermektedir (p=0,012). Evreleme grubunda prostat SUVmax ve en yüksek SUVmax değerleri ile GG ve PSA değerleri arasında orta düzeyde korelasyon saptanmıştır (sırasıyla r=0,42, r=0,5, r=0,54, r=0,53). “Gleason Grade” 2 ve altında olan hastalar ile 2’nin üzerinde olan hastaların, prostat SUVmax ve en yüksek SUVmax değerleri anlamlı farklılık göstermektedir (sırasıyla p=0,005, p=0,002). PSA değeri 20 ng/ml ve altında olan hastalar ile 20 ng/ml’nin üzerinde olan hastaların prostat SUVmax değerleri anlamlı farklılık göstermektedir (p= 0,045). Yeniden evreleme grubunda visseral organ ve en yüksek SUVmax değerleri ile PSA değerleri arasında orta düzeyde korelasyon saptanmıştır (sırasıyla r=0,56, r=0,43). Ga-68 PSMA PET/BT’de patolojik bulgu saptanmayan hastalar ile patolojik bulgu saptanan hastalar arasında; PSA değerleri, GS, GG anlamlı farklılık göstermektedir (sırasıyla p<0,001, p=0,032, p=0,030).
Sonuç: Çalışma bulgularımız orta-yüksek risk grubundaki hastalarda evreleme amaçlı, nüks şüphesi veya biyokimyasal nüks durumu olan hastalarda yeniden evreleme amaçlı PSMA PET/BT görüntülemesinin rutin kullanıma girmesi gerektiğini düşündürmektedir. PSMA PET/BT’de saptanan bulguların ve SUVmax değerlerinin, gerek histopatolojik, gerek laboratuvar bulguları ile ilişkili olması, SUVmax değerlerinin de prognostik faktör olarak kullanılabileceğini düşündürmektedir.

Keywords

Ga-68 PSMA PET/BT, SUVmax, Gleason Skoru, Gleason Grade

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