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Our purpose was to explore the value of 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT for detection of phosphatase and tensin homolog (PTEN)-loss prostate cancer. Methods: We retrospectively enrolled 75 patients who underwent multiparametric MRI and 68 Ga-PSMA PET/CT before radical prostatectomy. Lesions were outlined on pathologic images, and regions of interest were drawn on matched multiparametric MRI and PET/CT images. Imaging parameters, including average apparent diffusion coefficient and SUV max , were derived. Immunohistochemical staining was performed to evaluate the PTEN status. The diagnostic performance of imaging parameters was analyzed by receiver-operating-characteristic analysis. Univariate logistic regression analyses were used to evaluate the association between clinical and imaging variables and PTEN status. Results: In total, 103 lesions from 75 patients were analyzed. Of these lesions, 38 of 103 (36.9%) showed PTEN-loss status. Our study showed a strong association between SUV max and PTEN-loss tumors both in the per-patient analysis ( P &lt; 0.01) and in the per-lesion analysis ( P &lt; 0.01), yielding sensitivity and specificity of 0.80 and 0.77, respectively, in the per-patient analysis and 0.83 and 0.74, respectively, in the per-lesion analysis. Meanwhile, higher pathologic PSMA expression was found in the PTEN-deficiency tumors. However, there was no significant difference between PTEN-loss tumors and PTEN-intact tumors using parameters such as average apparent diffusion coefficient ( P &gt; 0.05) and score on the Prostate Imaging Reporting and Data System, version 2 ( P &gt; 0.05). Surprisingly, SUV max was a significant predictor for detection of PTEN-loss tumors (odds ratio of 7.56 and 95% confidence interval of 2.18-26.24 on per-patient analysis; odds ratio of 13.66 and 95% confidence interval of 4.32-43.24 on per-lesion analysis). Conclusion:  68 Ga-PSMA PET/CT could effectively detect aggressive PTEN-loss tumors.

Diagnostic Value of68Ga-PSMA PET/CT for Detection of Phosphatase and Tensin Homolog Expression in Prostate Cancer: A Pilot Study

Diagnostic Value of⁶⁸Ga-PSMA PET/CT for Detection of Phosphatase and Tensin Homolog Expression in Prostate Cancer: A Pilot Study