Different expression parameters of 18 F-FDG combined with 18 F-PSMA-1007 PET/CT imaging can predict pathological grading of prostate cancer

YAO Xiaolong; NA Renhua; DAI Zeqiang; LIU Bing; YANG Xiaofeng; ZHU Haixu; CHAI Liming

doi:10.12122/j.issn.1674-4500.2025.06.04

Abstract：Objective To investigate the predictive value of diverse expression parameters of 18F-FDG and 18F-PSMA-1007 PET/CT imaging for pathological grading of prostate cancer.Methods A retrospective analysis was carried out on the clinical characteristics,as well as 18F-FDG and 18F-PSMA-1007 PET/CT imaging data of 235 patients who were initially diagnosed with prostate cancer at the People's Hospital of Xinjiang Uygur Autonomous Region from July 2022 to May 2024.The enrolled patients were classified into the low-grade group and high-grade group according to the Gleason grading system.Mann-Whitney U test was employed to compare the differences in total prostate specific antigen(TPSA)and each expression parameter of PET/CT before treatment between the two groups.Spearman's rank correlation coefficient was utilized to analyze the correlation between different expression parameters and the International Society of Urological Pathology(ISUP)grouping,as well as pre-treatment TPSA values.A binary multifactorial logistic regression model was adopted to identify the independent predictors of prostate cancer pathological grading.Additionally,ROC curves were used to evaluate the predictive efficacy of different expression parameters for high-grade prostate cancer.Results Statistically significant differences was observed in the different expression parameters between the two groups(P<0.001).Spearman's rank correlation coefficient analysis indicated that each expression parameter of both imaging modalities was positively correlated with ISUP grading and pre-examination TPSA values.Binary multifactorial logistic regression analysis revealed that only SUVmax2 of 18F-PSMA-1007 PET/CT imaging was an independent predictor of ISUP grading,with an OR of 0.54(0.293-0.993,P=0.047).PSMA-TV and TL-PSMA had the largest areas under the ROC curve(0.950 and 0.928,respectively,P<0.001).Conclusion 18F-PSMA-1007 PET/CT expression parameters,namely SUVmax2,PSMA-TV,and TL-PSMA,exhibit greater advantages in the early prediction of prostate cancer pathologic grading.