Abstract
BackgroundThe purpose of this study was to evaluate the imaging properties of hepatic metastases in 68Ga-PSMA positron emission tomography (PET) in patients with prostate cancer (PC).Methods68Ga-PSMA-PET/CT scans of PC patients available in our database were evaluated retrospectively for liver metastases. Metastases were identified using 68Ga-PSMA-PET, CT, MRI and follow-up scans. Different parameters including, maximum standardized uptake values (SUVmax) of the healthy liver and liver metastases were assessed by two- and three-dimensional regions of interest (2D/3D ROI).ResultsOne hundred three liver metastases in 18 of 739 PC patients were identified. In total, 80 PSMA-positive (77.7%) and 23 PSMA-negative (22.3%) metastases were identified. The mean SUVmax of PSMA-positive liver metastases was significantly higher than that of the normal liver tissue in both 2D and 3D ROI (p ≤ 0.05). The mean SUVmax of PSMA-positive metastases was 9.84 ± 4.94 in 2D ROI and 10.27 ± 5.28 in 3D ROI; the mean SUVmax of PSMA-negative metastases was 3.25 ± 1.81 in 2D ROI and 3.40 ± 1.78 in 3D ROI, and significantly lower than that of the normal liver tissue (p ≤ 0.05). A significant (p ≤ 0.05) correlation between SUVmax in PSMA-positive liver metastases and both size (ρSpearman = 0.57) of metastases and PSA serum level (ρSpearman = 0.60) was found.ConclusionsIn 68Ga-PSMA-PET, the majority of liver metastases highly overexpress PSMA and is therefore directly detectable. For the analysis of PET images, it has to be taken into account that also a significant portion of metastases can only be detected indirectly, as these metastases are PSMA-negative.
Highlights
The purpose of this study was to evaluate the imaging properties of hepatic metastases in 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET) in patients with prostate cancer (PC)
Radiolabeled prostate-specific membrane antigen (PSMA) ligands such as 68Ga-PSMA-HBED-CC have been introduced as a promising radiotracer for the PET imaging of PC [2]
Correlation between size and SUVmax of liver metastases We calculated a moderate significant positive relationship between size and SUVmax of PSMA-positive metastases (Fig. 5a, ρSpearman = 0.568, 95% CI [0.397; 0.701], p ≤ 0.001)
Summary
The purpose of this study was to evaluate the imaging properties of hepatic metastases in 68Ga-PSMA positron emission tomography (PET) in patients with prostate cancer (PC). Methods: 68Ga-PSMA-PET/CT scans of PC patients available in our database were evaluated retrospectively for liver metastases. There are reports of patients with liver metastases as the first site of metastatic disease and the liver representing the only metastatic site [10, 12, 13]. In this patient collective, early and reliable detection of liver
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