What’s behind 68Ga-PSMA-11 uptake in primary prostate cancer PET? Investigation of histopathological parameters and immunohistochemical PSMA expression patterns

• DOI: 10.1007/s00259-021-05501-1
• Publication Date: 2021-08-13T03:34:09Z
• Authors: Jan H. Rüschoff; Daniela A. Ferraro; Urs J. Muehlematter; Riccardo Laudicella; Thomas Hermanns; Ann-Katrin Rodewald; Holger Moch; Daniel Eberli; Irene A. Burger; Niels J. Rupp
• Keywords: Glutamate carboxypeptidase II; PET-CT

Prostate-specific membrane antigen (PSMA-) PET has become a promising tool in staging and restaging of prostate carcinoma (PCa). However, specific primary tumour features might impact accuracy PSMA-PET for PCa detection. We investigated histopathological parameters immunohistochemical PSMA expression patterns on radical prostatectomy (RPE) specimens correlated them to the corresponding 68Ga-PSMA-11-PET examinations.RPE 62 patients with preoperative between 2016 2018 were analysed. WHO/ISUP grade groups, growth pattern (expansive vs. infiltrative), area diameter as well heterogeneity, intensity negative (PSMA%neg) spatially SUVmax multidisciplinary analysis.All tumours showed medium strong membranous (2-3 +) weak cytoplasmic (1-3 expression. Heterogeneously expressed was found 38 cases (61%). Twenty-five (40%) at least 5% up 80% PSMA%neg. PSMA%neg, infiltrative pattern, smaller group 2 significantly lower values. A ROC curve analysis revealed 20% PSMA%neg an optimal cutoff highest sensitivity specificity (89% 86%, AUC 0.923) scan. multiple logistic regression model tumoural (p < 0.01, OR = 9.629) 0.0497, 306.537) significant predictors scan.We describe size associated 68Ga-PSMA-11 uptake cancer. These findings can serve fundament future biopsy-based biomarker development enable individualized, tumour-adapted imaging approach.