Combined use of 18F-PSMA-1007 PET/CT and clinical indicators effectively predicts different metastatic states in prostate cancer
ZHANG Wenxian
LI Xiaohong
ZHANG Qizhou
LI Yubin
ZHAO Xiaojia
Abstract：Objective To evaluate the relationship between distinct metastatic stages(non-metastatic,oligometastatic,and polymetastatic)of prostate cancer and 18F-prostate-specific membrane antigen(PSMA)-1007 PET/CT imaging characteristics together with clinical parameters.Methods A retrospective analysis was conducted on 269 pathologically confirmed prostate cancer patients who underwent 18F-PSMA-1007 PET/CT at the First Affiliated Hospital of Xinjiang Medical University from February 2022 to May 2025.Based on imaging findings,patients were categorized into non-metastatic(n=107),oligometastatic(n=60),and polymetastatic(n=102)groups.Comparative analysis of clinical and imaging parameters among groups was performed.Variables significant on univariate analysis were entered into multivariable logistic regression.ROC curves were constructed to evaluate the discriminative performance of risk factors for polymetastasis.Results Univariate analysis demonstrated significant differences(P<0.05)among groups in total prostate-specific antigen(TPSA),prostate-specific antigen density,free PSA(FPSA),the FPSA/TPSA ratio,Gleason score,International Society of Urological Pathology(ISUP)grading(low grade:1-3;high grade:4-5),tumor-to-background ratio(TBR),maximum standardized uptake value(SUVmax),mean SUV(SUVmean),total lesion glycolysis,metabolic tumor volume(MTV),and prostate volume(PV).Multivariable logistic regression revealed FPSA and ISUP as independent predictors of oligometastasis(P<0.05),while SUVmean,MTV,TPSA,PV,and ISUP were independent predictors of polymetastasis(P<0.05).ROC analysis indicated that TPSA achieved the highest diagnostic accuracy for polymetastasis(AUC=0.88,specificity=90.4%),whereas SUVmean demonstrated the highest sensitivity(94.1%).MTV and PV showed lower AUCs,sensitivity,and specificity compared with TPSA and SUVmean,with no significant differences between the MTV and PV metrics.Conclusion Integrating 18F-PSMA-1007 PET/CT metabolic parameters with clinical indicators enhances stratification of metastatic burden in prostate cancer.FPSA and ISUP are independent predictors of oligometastasis,while TPSA,SUVmean,MTV,PV,and ISUP serve as independent determinants of polymetastasis.
Keywords：prostate canceroligometastasisrisk factors
Publication Date：2026-01-20
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 50-55 )