Abstract:

Purpose: Metastatic prostate cancer diagnosed with castration-resistant under Abirateron/Enzalutamide treatment is to study the role of 68Ga-PSMA PET/BT in predicting prostate-specific antigen (PSA) response using a pathological parameter such as alkaline phosphatase (ALP), laktate dehydrogenesis (LDH) with quantitative PET parameters such as SUVmax, SUVmean, Highest SUVpeak, PSMA-TV and TL-PSMA. Tools and Methods: This retrospective-designed study included 45 patients who began treatment with Abirateron/Enzalutamide after PSMA PET/BT screening in our clinic between January 2018 and January 2021. All bodies obtained from the pre-treatment PSMA PET/BT from all patients were identified and recorded with the TL-PSMA, PSMA-TV, Highest SUVpeak(HPeak), Highest Background normalized SUVpeak (HBNSUVPeak), HSUVmax, HSUVmean, HBNSUVmax, HBNSUVmean, pre-treatment and post-treatment PSA values. Results: The cut-off value for predicting progression with ROC curves was ≥112,53 cm3 for PSMA-TV (AUC: 0.930±0.37 p<0.001), ≥857,1 for TL-PSMA (AUC: 0.16±0.44 p<0.001) and ≥16.36 g/ml for Hpeak (AUC: 0.721±071 p=0.075) and has a high sensitivity and specificity value for predicting the progression of the remaining area under the curve and has been statistically meaningful. Univariant logistics regression analysis in PSMA-TV (≥112.53 cm3) and TL-PSMA (≥857. 1) whereas the values are statistically meaningful in predicting progression (OR and p values are OR:29.7 p<0.001 and OR:116, p<0.001 respectively). In the multivariant logistics regression analysis, the value of TL-PSMA (≥857.1) was found as an independent prognostic factor in predicting progress (OR: 55.88, p:0.005). The result: with the 68Ga-PSMA PET/BT parameter, TL-PSMA suggests that the progression of the disease is an independent prognostic factor in prediction and that patients who are not beneficial from the treatment of Abirateron/Enzalutamide can contribute to the direction of different therapeutic alternatives by determining before treatment.

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