The clinical predictive value of radiomic features from [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET in patients with prostate cancer: a preliminary comparative study

Purpose To perform a preliminary evaluation of the clinical predictive value of radiomics from [Ga-68]Ga-PSMA-11 PET and [F-18]F-PSMA-1007 PET Positron Emission Tomography (PET) images of primary/recurrent prostate cancer (PCa) patients. Methods Institutional PCa patients undergoing a staging/restaging [Ga-68]Ga-PSMA-11 or an [F-18]F-PSMA-1007 PET/computed tomography (CT) in 2021-2022 were retrospectively selected. Prostate specific antigen (PSA), Gleason Score (GS), lymph node status (N) and distant metastases (M) were collected. Volume of interests (VOIs) were placed to contour abnormal PSMA PET findings within the prostatic gland/fossa suspected for PCa. One hundred thirty-three radiomic features of both PSMA PET radioligands were extracted from each VOI, to explore their predictive value for the above-mentioned clinical/histological data. Results Among 42 patients retrospectively included, significant different Total Lesion PSMA volumes (TL-PSMA) were found between the low/intermediate and high GS subgroups if this feature derived from [F-18]F-PSMA-1007 PET images (Mann-Whitney Test, p = 0.01). TL-PSMA values were found significantly different between the two GS subgroups when the entire cohort of both [Ga-68]Ga-PSMA-11 and [F-18]F-PSMA-1007 was considered (Mann-Whitney test, p = 0.004). The Minimum histogram gradient intensity feature was found to significantly predict the N-status (Mann Whitney test, p = 0.009). No correlations were found between the radiomic features and PSA values or M-status. Conclusion Prostate TL-PSMA and Minimum histogram gradient intensity features of [Ga-68]Ga-PSMA-11 PET and [F-18]F-PSMA-1007 PET are candidate for building predictors of both high GS and N status in patients with PCa. [F-18]F-PSMA-1007 PET-derived TL-PSMA seem to correlate better than [Ga-68]Ga-PSMA-11 with high GS.