Modelo radiómico con PSMA-PET para la discriminación de pacientes con cáncer de próstata de alto riesgo

Montserrat  Carles Fariña; Constatinos Zamboglou; Tobias Fechter; Selina  Kiefer; Kathrin  Reichel; Martin  Werner; Cordula A Jilg; Luis  Martí-Bonmatí; Dimos Baltas; Michael Mix; Anca L.  Grosu

doi:10.37004/sefm/2022.23.2.002

Authors

Montserrat Carles Fariña La Fe Health Research Institute, Biomedical Imaging Research Group (GIBI230-PREBI) and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain https://orcid.org/0000-0003-2401-8240
Constatinos Zamboglou Department of Radiation Oncology, University Medical Center Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
Tobias Fechter Department of Radiation Oncology, Division of Medical Physics, University Medical Center Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
Selina Kiefer Institute for Surgical Pathology, Medical Center – University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
Kathrin Reichel Department of Urology, Medical Center – University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
Martin Werner Institute for Surgical Pathology, Medical Center – University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
Cordula A Jilg Department of Urology, Medical Center – University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
Luis Martí-Bonmatí https://orcid.org/0000-0002-8234-010X
Dimos Baltas Department of Radiation Oncology, Division of Medical Physics, University Medical Center Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
Michael Mix Department of Nuclear Medicine, University Medical Center Freiburg, Faculty of Medicine, 79106 Freiburg, Germany
Anca L. Grosu Department of Radiation Oncology, University Medical Center Freiburg, Faculty of Medicine, 79106 Freiburg, Germany

DOI:

https://doi.org/10.37004/sefm/2022.23.2.002

Keywords:

Prostate Cancer, PSMA-PET, radiomic models, Gleason score

Abstract

In patients with prostate cancer (PCa), the characterization of the Gleason score (GS) by radiomic models is of special interest as a non-invasive alternative to biopsy and because it allows stratifying the level of risk and supporting treatment decision. Our aim was to obtain a [68Ga]-Prostate Specific-Membrane-Antigen (PSMA) Positron-Emission-Tomography (PET) radiomic model to characterize GS in PCa. In 60 patients, tumors were manually segmented and for the 20 prospective patients, histopathological co-registration was additionally segmented. For 133 radiomic features (RFs) we evaluated: intrinsic dependence with volume and with different PET/TC equipment, their values inside and outside the prostatic tumor and the GS characterization. Wilcoxon signed-rank test, Spearman correlation and logistic regression were used as methods of analysis. The results show that 50 RFs were intrinsically volume independent and discriminated the tumor from the rest of the prostate, regardless of the segmentation method applied. The GS was characterized (G < 8 vs G ≥ 8) by a RF with area-under-the-curve (AUC) of 0.91/0.84 for the initial/validation cohort and by a radiomic signature (AUC 0.93/0.78). It can be concluded that noninvasive characterization of GS with 68Ga- PSMA-PET radiomic models is feasible.

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