Role of PSMA PET/CT in evaluation of therapy response in patients with metastatic prostate cancer

Abstract

Author(s): Ahmed Badawy, Sherif El Refaei, Maha Abd El-Kareem, Marwa Abdallah Hassan, Mohamed Houseni

Background: Even though PSMA PET/CT is the imaging technique for prostate cancer that is growing at the quickest pace, its widespread utilization must be supported by clear guidelines for when and how to deploy it. This is because PSMA PET/CT is the imaging tool that is increasing at the fastest rate. PSMA PET/CT has shown promise as a diagnostic tool that could be utilized in a diverse range of therapeutic settings.

Aim: To determine the extent to which PSMA PET/CT may be used to predict how well individuals who have metastatic prostate cancer will respond to treatment based on the criteria established by Positron Emission tomography Response Criteria In Solid Tumors (PERCIST).

Methods: In this study, there were a total of 53 male participants, all of whom had pathologically established instances of metastatic prostatic adenocarcinoma and participated in both the initial PSMA-PET/CT study and the post-therapy PSMA-PET/CT study. The medical histories of every individual were examined in great detail. The collection of data comprised the patient's medical history, histology, age, weight, height, the type of therapy that was administered, pre-and post-treatment PSA levels (biochemical response), and serum creatinine levels that were completed no more than 2 weeks before the study (in individuals who had received IV contrast).

Results: Regarding post-therapy response by PET/CT (PERCIST criteria); 38 patients out of 53 (71.7%) were responders to therapy including patients with partial response, stable disease, and complete response. 15 patients out of 53 (28.3%) were non-responders to treatment including patients with progressive disease. Regarding post-therapy response by CT study (RECIST criteria); 30 cases out of 41 (73.2%) were responders to therapy including patients with partial response, stable disease, and complete response and 11 cases out of 41 (26.8%) were non-responders to treatment including progressive disease. There is good agreement among PERCIST and RECIST criteria with Kappa value=0.75 mostly seen in the cases with partial response with 16 cases (42.1%). The agreement between biochemical response and post-therapy PSMA-PET study was assessed on 53 patients and found that there is a moderate agreement with Kappa value=0.57 mostly seen in the patients with partial response with 25 patients (47.2%).

Conclusion: there was moderate agreement among post-therapy biochemical response and PERCIST as well as RECIST criteria. There was a good agreement among PERCIST and RECIST criteria

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