DOI: 10.1097/mnm.0000000000002224 ISSN: 0143-3636

68Ga prostate-specific membrane antigen PET/computed tomography in benign and malignant prostatic lesions: a study of maximum standardized uptake value and uptake patterns with clinicopathological correlation

Prathamesh Mangale, Archi Agrawal, Sayak Choudhury, Gagan Prakash, Vedang Murthy, Amit Joshi, Santosh Menon, Mahendra Pal, Venkatesh Rangarajan

Aim

Assessment of maximum standardized uptake value (SUV max ) values and patterns of uptake on 68 Ga prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) in benign and malignant prostatic lesions.

Methods

Retrospective observational study of prostate cancer patients referred for 68 Ga-PSMA PET/CT for initial staging. SUV max of the prostatic lesion was correlated with risk category, International Society of Urological Pathology (ISUP) grade groups, prostate-specific antigen (PSA), and Gleason score. Uptake patterns across risk categories were also evaluated.

Results

A total of 325 subjects were included (14 benign and 311 malignant). Median SUV max of benign lesions was 8.29. Grade groups 4 and 5 showed significantly higher median SUV max values (26.42 and 26.55) than other grade groups. SUV max correlated positively with ISUP grade group, Gleason score, and serum PSA (all P < 0.001). SUV max differed significantly among benign/low‐, intermediate‐, and high-risk groups. Receiver operating characteristic analysis identified an SUV max cut-off of 10.91 for diagnosing prostate cancer, with 80% sensitivity, 79% specificity, 98.8% positive predictive value, and 80% diagnostic accuracy. Uptake pattern within the prostate did not differ significantly across risk categories.

Conclusion

SUV max differentiates high-risk from low‐ and intermediate-risk prostate cancer and may serve as a noninvasive independent prognostic marker. Intraprostatic uptake pattern has no significant role in lesion categorization.

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