The appropriateness of PSMA PET/CT in newly diagnosed unfavorable intermediate-risk prostate cancer patients-towards a tumor volume-based risk stratification

Marinus J Hagens; Wietske I Luining; Liselotte M S Boevé; Remco J J Knol; Ton A Roeleveld; Sandra Srbljin; Saskia Weltings; Jose C C Koppes; Daniela E Oprea-Lager; André N Vis; Pim J van Leeuwen; Henk G van der Poel

doi:10.1038/s41391-024-00899-9

The appropriateness of PSMA PET/CT in newly diagnosed unfavorable intermediate-risk prostate cancer patients-towards a tumor volume-based risk stratification

Prostate Cancer Prostatic Dis. 2024 Sep 23. doi: 10.1038/s41391-024-00899-9. Online ahead of print.

Authors

Marinus J Hagens^#^{1

2

3}, Wietske I Luining^#^{4

5}, Liselotte M S Boevé⁶, Remco J J Knol⁷, Ton A Roeleveld^{5

8}, Sandra Srbljin⁹, Saskia Weltings¹⁰, Jose C C Koppes¹¹, Daniela E Oprea-Lager¹¹, André N Vis^{4

5}, Pim J van Leeuwen^{12

5}, Henk G van der Poel^{12

4

5}

Affiliations

¹ Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands. [email protected].
² Department of Urology, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands. [email protected].
³ Prostate Cancer Network Netherlands, Amsterdam, The Netherlands. [email protected].
⁴ Department of Urology, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands.
⁵ Prostate Cancer Network Netherlands, Amsterdam, The Netherlands.
⁶ Department of Urology, OLVG, Amsterdam, The Netherlands.
⁷ Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
⁸ Department of Urology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
⁹ Department of Nuclear Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.
¹⁰ Department of Urology, Zaans Medisch Centrum, Zaandam, The Netherlands.
¹¹ Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands.
¹² Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.

^# Contributed equally.

PMID: 39313655
DOI: 10.1038/s41391-024-00899-9

Abstract

Background/objectives: This study reassesses the diagnostic value of PSMA PET/CT in unfavorable intermediate-risk prostate cancer (PCa) and validates the Prostate Cancer Network the Netherlands (PCNN) subclassification.

Subjects/methods: Men subjected to PSMA PET/CT were analyzed, evaluating the incidence of metastatic disease and its correlation with PCNN subgroups.

Results: Metastatic disease was identified in 12.4% of patients. Higher PCNN subgroups correlated with increased metastatic potential; odds were significantly lower in low metastatic potential cases (OR: 0.19, 95% CI 0.06-0.62; p = 0.01).

Conclusions: Our findings reaffirm PSMA PET/CT's diagnostic value in unfavorable intermediate-risk PCa and validate the PCNN subclassification, reducing scan burden by 48.1%.