Feasibility Study of PERCIST In The Efficacy Evaluation of [ 18 F] -PSMA-1007 PET/CT In Patients With Prostate Cancer Receiving Systematic Treatment

Abstract

Abstract Purpose Positron Emission Tomography (PET) Response Criteria in Solid Tumors (PERCIST) is a tumor efficacy evaluation standard developed for 2-deoxy-2-[18F]fluoro-D-glucose ([18F]-FDG) PET/CT, We applied this standard to [18F]-coagulate specific membrane antigen-1007 (PSMA) PET/CT in patients with prostate cancer, the standardized uptake value corrected for lean body mass (SUL)was used as metabolic parameter. We compared the consistency between the efficacy evaluation of SUL and prostate specific antigen (PSA), and analyzed the effect of prostate cancer-related clinical factors on consistency. Finally, we attempted to apply the new PSMA efficacy evaluation criteria in 2021 Consensus Statements to this study. Procedures : We enrolled 41 men with prostate cancer, who underwent [18F] -PSMA-1007 PET/CT before and after therapy with radiation, androgen deprivation, or chemotherapy, quantitative analysis of positive lesions (at most 5 lesions in a single examination), obtain metabolic parameters,including Summed SULmax,Summed SULmean, Summed SULpeak, whole-body PSMA tumor volume (PSMA-TV), whole-body total lesion PSMA (TL-PSMA). The efficacy of the enrolled patients was evaluated according to PERCIST criteria, Kappa consistency test was carried out between the evaluation results of different parameters and the changes of serum PSA. Logistics regression was used to analyze the impact of clinical factors related to prostate cancer on the efficacy evaluation of PSMA. The new disease progression criteria in 2021 Consensus Statements are used to evaluate efficacy. Result 41 patients received systematic treatment, 6 patients achieved complete response(CR) to biochemical indicators PSA, 20 patients partial response(PR), 6 patients stable disease(SD), 9 patients progressive disease(PD), Summed SULmax (22/41, Kappa 0.306), Summed SULmean (23/41, Kappa 0.342), Summed SULpeak (23/41, Kappa 0.381), PSMA-TV (22/41, Kappa 0.331), TL-PSMA(26/41, Kappa 0.431). Logistic regression analysis showed that clinical factors associated with prostate cancer(including PSA level, Gleason score, metastatic status, and sensitivity to hormone therapy) did not affect the consistency of PSMA PET/CT metabolic parameters with PSA assessment(P > 0.05). The progress criteria in 2021 consensus statements changed the outcome of the metabolic parameters assessment in 2 patients. Conclusions SUL metabolic parameters were consistent with PSA in the efficacy assessment of [18F]-PSMA PET/CT, and were not affected by clinical factors related to prostate cancer, the PERCIST standard can be used in PSMA imaging. Progress criteria in 2021 Consensus Statements could improve consistency between PSMA metabolic parameters and PSA assessment in some patients.