Imply on diagnosis and early prognosis of preoperative [Ga]Ga-PSMA-11 PET/CT in patients with suspected brain tumours of glial origin.

in Scientific reports by K Pełka, K Koczyk, L Koperski, T Dziedzic, A Nowak, L Królicki, P Kunert, J Kunikowska

TLDR

  • The study evaluated the diagnostic accuracy and prognostic value of [Ga]Ga-PSMA-11 PET/CT in patients with glioma tumours.
  • The results suggest that [Ga]Ga-PSMA-11 PET/CT may be a useful diagnostic tool and potentially prognostic factor in glioma tumours.

Abstract

PET/CT targeting prostate-specific membrane antigen (PSMA) is commonly used in patients with prostate cancer. PSMA has been found in other solid tumours, including primary brain tumours. The aim of this study was to evaluate the usefulness of [Ga]Ga-PSMA-11 PET/CT for preoperative diagnosis and 2-year prognosis. We prospectively screened patients with suspected glioma tumour. The PET/CT qualitative and quantitative results were compared to the histopathological examination. We compared glioblastoma (GBM) diagnostic data or between high-grade (HGG) and low-grade (LGG) gliomas. Overall (OS) and progression free survival (PFS) were analysed. Forty-four patients met the inclusion criteria. Twenty of them had positive and twenty-four negative scans. The sensitivity, specificity, positive predictive value, and negative predictive value for HGG diagnosis were 71.4 (95% confidence interval - 51.3-86.8), 100.0 (79.4-100.0), 100.0 (83.1-100.0), and 66.7 (44.7-84.4), respectively. For differentiation between GBM vs non-GBM tumours, the best parameter was the tumour-to-background ratio, with the area under the receiver operating characteristic curve 0.81 (0.66-0.96; 42.2) (95% CI; cut-off). Patients with positive PET/CT scans had similar PFS and OS to patients with HGG. PSMA accumulation negatively affected the PFS and OS of patients with diagnosed GBM. [Ga]Ga-PSMA-11 PET/CT showed optimistic diagnostic results and may be prognostic a factor.Registration at www.clinicaltrials.gov 09/06/2023 with number NCT05896449.

Overview

  • The study aimed to evaluate the usefulness of [Ga]Ga-PSMA-11 PET/CT in diagnosing glioma tumours and predicting 2-year prognosis.
  • The study prospectively screened patients with suspected glioma tumours and compared PET/CT results to histopathological examination.
  • The primary objective was to determine the sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT for the diagnosis of high-grade gliomas.

Comparative Analysis & Findings

  • The study found that [Ga]Ga-PSMA-11 PET/CT had a sensitivity of 71.4% and specificity of 100% for diagnosing high-grade gliomas.
  • The best parameter for differentiating between glioblastoma and non-glioblastoma tumours was the tumour-to-background ratio, with an area under the receiver operating characteristic curve of 0.81.
  • Patients with positive PET/CT scans had similar progression-free survival and overall survival to patients with high-grade gliomas, whereas PSMA accumulation negatively affected progression-free survival and overall survival in patients with diagnosed glioblastoma.

Implications and Future Directions

  • The study suggests that [Ga]Ga-PSMA-11 PET/CT may be a useful diagnostic tool for glioma tumours and potentially a prognostic factor.
  • Further studies are needed to validate the findings and to explore the potential role of PSMA accumulation in glioblastoma prognosis.
  • Future research directions may include investigating the use of [Ga]Ga-PSMA-11 PET/CT in combination with other diagnostic tools and exploring the potential therapeutic targets of PSMA in glioblastoma.
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