[The intensity of PSMA intraprostatic uptake as a predictor of clinically significant prostate cancer].

Introduction: Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) improves prostate cancer staging. Furthermore, the intensity of intraprostatic uptake of PSMA can predict clinically relevant oncologic outcomes. The objective of this study is to evaluate whether the intensity of PSMA uptake is associated with clinically significant prostate cancer and to determine which value of PSMA uptake best discriminates this relationship.

Methods: A cohort study of 40 patients with biopsy-proven prostate cancer prior to external radiotherapy was conducted. The correlation between intraprostatic PSMA uptake intensity and adverse pathological findings in prostate biopsy was evaluated. Which PSMA uptake value better discriminates clinically significant prostate cancer was assessed using ROC curves.

Results: Forty percent of the patients had a clinically significant prostate cancer and the maximum standardized uptake value (SUV max) had a mean of 11.5 (SD ± 7). The sample showed a Spearman correlation coefficient of 0.4 (p = 0.007). The area under the curve (AUC) was 0.73 and a SUV max = 9.5 showed a sensitivity of 0.81 and a specificity of 0.71 in the detection of clinically significant prostate cancer.

Conclusion: Intraprostatic PSMA uptake intensity can be a new diagnostic tool in the detection of clinically significant prostate cancer. An uptake intensity equal or greater than 9.5 is correlated with clinically significant prostate cancer.