Correlation of intraprostatic lesional SUVmax during PSMA PET/CT and adverse pathology at radical prostatectomy.

Authors

Felix Preisser, Florian Nohe, Ken Herrmann, Philipp Mandel, Tobias Maurer, Markus Graefen, Derya Tilki

Published in

Prostate cancer and prostatic diseases. Aug 24, 2026. Epub Aug 24, 2026.

Abstract

Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is a novel staging modality for prostate cancer (PCa) patients with a high positive predictive value for lesions within and outside of the prostate. To assess the ability of the maximum standardized uptake value (SUVmax) at PSMA PET/CT to predict adverse pathology at radical prostatectomy (RP).
Within a high-volume center database, we identified intermediate and high-risk PCa patients who had a PSMA PET/CT with an available intraprostatic SUVmax before RP between 2016 and 2021. Logistic regression modeling was used to test for the ability of SUVmax to predict non-organ confined disease or adverse pathology (non-organ confined and/or Gleason grade group ≥3) during RP. Kaplan-Meier analyses were used to compare biochemical recurrence (BCR)-free survival after RP stratified according to SUVmax.
Overall, 544 patients were identified. Of those, median lesional intraprostatic SUVmax was 9.5 at PSMA PET/CT. Median PSA was 8.1 ng/ml prior to RP. 50.7% vs. 49.3% had D'Amico intermediate and high-risk characteristics. Median follow-up was 24.6 months. BCR-free survival at 48 months after RP was 72.1% vs. 62.2% (p = 0.03) for patients with SUVmax <9.5 vs. SUVmax ≥9.5 at PSMA PET. In logistic regression models, SUVmax (continuously coded and stratified in <9.5 vs. ≥9.5) represented an independent predictor for non-organ confined disease and adverse pathology.
SUVmax ≥9.5 at PSMA PET/CT is an independent predictor of adverse pathology at RP. Moreover, it is associated with worse BCR-free survival after RP.

PMID:
42637826
Bibliographic data and abstract were imported from PubMed on 25 Aug 2026.

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