Identification of the Optimal Cut-Off Value of PSA for Assessing Severity of Disease in [ 68 Ga]Ga-PSMA-11 PET/CT Study in Prostate Cancer Patients after Radical Prostatectomy

• Published in: Diagnostics (Basel) Vol. 12; no. 2; p. 349
• Main Authors: Cegla, Paulina, Wojewódzka, Marta, Gorczewska, Izabela, Chalewska, Wioletta, Łapińska, Grażyna, Ochman, Paweł, Sackiewicz, Agata, Dedecjus, Marek
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 29.01.2022; MDPI
• Subjects: Antigens; Cancer therapies; Nuclear medicine; positron emission tomography/computed tomography; Prostate cancer; prostate-specific membrane antigen; Tomography; Poland; United States > US; positron emission tomography/computed tomography; prostate cancer; prostate-specific membrane antigen
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12020349

The objective of this study was to identify the optimal cut-off value of prostate specific antigen (PSA) to assess the extent of the disease in [ Ga]Ga-PSMA-11 PET/CT study in patients after radical prostatectomy. Retrospective analysis was performed on a group of 215 patients who underwent a [ Ga]Ga-PSMA-11 PET/CT examination because of suspected recurrence after radical prostatectomy. Patients were divided into four groups: 1, no active lesions suggesting recurrence (n = 92); 2, suspected isolated local recurrence (n = 19); 3, oligometastatic disease (n = 82); and 4, polymetastatic disease (n = 22). In group 1, the mean PSA level was 0.962 ng/mL (median: 0.376; min: 0.004; max: 25 ng/mL); in group 2, it was 4.970 ng/mL (median 1.320; min: 0.003; max: 40.350 ng/mL); in group 3, it was 2.802 ng/mL (median: 1.270; min: 0.020; max: 59.670 ng/mL); and in group 4, it was 4.997 ng/mL (median: 3.795; min: 0.007; max 21.110 ng/mL). Statistically significant differences were shown in PSA levels when comparing groups 1 and 2 ( = 0.0025) and groups 3 and 4 ( = 0.0474). The PSA cut-off point for discriminating groups 1 and 2 was 0.831 (sensitivity: 0.684; specificity: 0.772; area under the curve (AUC): 0.775), and for groups 3 and 4, it was 2.51 (sensitivity: 0.682; specificity: 0.780; AUC: 0.720). Our preliminary data suggested that the PSA level has an essential influence on determining the extent of disease in a [ Ga]Ga-PSMA-11 PET/CT study in patients after radical prostatectomy. Identification of the optimal cut-off values for the oligo- and polymetastatic diseases might be helpful in stratifying these patients.