The intra- and interobserver variability of PSMA-expression scores in patients with primary prostate cancer

Résumé fourni par la source

Currently, prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is increasingly employed for staging of patients with intermediate- and high-risk primary prostate cancer, as well as in patients experiencing recurrence after treatment with curative intent [ 1 , 2 ]. The immunohistochemical expression of PSMA in primary prostate cancer correlates to the Gleason Grade [ 3 ]. Similarly, most prostate tumours with high Gleason Grades and other poor prognostic parameters have higher PSMA-expression rates, as assessed on PSMA PET/CT [ 4 ]. The initial version of the Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) framework introduced a 4-point PSMA-expression score to describe the PSMA-expression of primary tumours and metastases, aiming to standardize the interpretation and reporting of PSMA-targeted imaging studies [ 5 ]. This PSMA-expression scoring system has been retained in the second version of the PROMISE framework [ 6 ] and is endorsed by the EANM guidelines [ 7 , 8 ]. The PSMA-expression score has been primarily proposed and used as a visual scale. However, limited information exists on the observer variability of the PSMA-expression score. Variations in interpretation among nuclear medicine readers and between different PSMA PET tracers may affect diagnostic interpretation and clinical decision-making regarding patient eligibility for PSMA-ligand directed radionuclide therapy [ 7 , 8 , 9 ].

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