The Role of Ga-68 PSMA PET/CT Scan on Differentiating of Oligometastatic and High Risk Prostate Cancer

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Objectives: In this study, we aimed to investigate whether Ga-68 prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) scanning is adequate to predict intermediate risk, high risk, or oligometastatic prostate cancer (PCa) as an initial staging modality.Methods: The Ga-68 PSMA PET/CT scan images of 50 PCa patients pathologically proven by transrectal ultrasound guided biopsy were evaluated retrospectively.The association of standard uptake value maximum (SUV max ) value of the area with the highest PSMA expression within the primary tumor with the risk groups and metastatic burden is investigated.Results: The SUV max value was 6.18 in oligometastatic patients where it was measured as 10.93 in patients with higher metastatic burden (p=0.037).The cut-off SUV max value for multiple metastases was 7.96 (p=0.047).According to the regression model, SUV max value has a positive influence [odds ratio (OR)=1.42],which was statistically significant (p=0.038).SUV max values for intermediate and high risk patients were 6.91 and 11.44, respectively (p=0.014).The cut-off SUV max value for the high risk group was 10.55 (p=0.006).In the regression model, SUV max value has a positive influence (OR=1.198),which was statistically significant (p=0.021).Conclusion: In this paper, we demonstrated the association between SUV max value of primary tumor and Gleason score.Our results also allowed us to suggest that primary tumor SUV max is a sufficiently accurate predictor of D'Amico risk groups in newly diagnosed PCa cases.Additionally, Ga-68 PSMA PET/CT turns out to be a useful tool in determining oligometastatic PCa, which requires a different treatment approach.