İsmail Emre ERGİN, Abuzer ÖZTÜRK, Aydemir ASDEMİR, Hüseyin SAYGIN, Zekiye HASBEK, Esat KORĞALI
Bulletin of Urooncology - 2026;25(2):47-52
Objective: This study aims to identify the maximum standardized uptake value (SUVmax) value that predicts the presence of oligometastatic and high-risk prostate cancer and forecasts disease behavior. Materials and Methods: In this retrospective analysis, patients who underwent 12-quadrant transrectal prostate biopsy in our clinic were evaluated in the study. D'Amico risk scoring was performed. Data of non-metastasis, oligometastatic and multimetastatic patients were recorded using imaging methods. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) SUVmax values, prostate-specific antigen (PSA) and pathology parameters were recorded. PSA and SUVmax values were compared between oligometastatic/multimetastatic and D'Amico risk groups. By performing receiver operating characteristic analyses, SUVmax values in predicting oligometastatic and high-risk disease were tried to be predicted. Results: According to the D'Amico risk scoring, there was no significant difference in SUVmax values between the low-risk group and the intermediate-risk group (p=0.18). However, a significant difference was observed between the intermediate-risk group and the high-risk group (p=0.006). According to the D'Amico risk classification, the best SUVmax cut-off value that distinguishes medium risk from high risk was 7.95, and the sensitivity for this value was found to be 73% and the specificity was 86%. The cut-off SUVmax value in distinguishing between oligometastatic and multimetastasis was found to be 12.65, and its sensitivity was 77% and specificity was 68%. The area under the curve was found to be 0.735. Conclusion: PSMA-PET should be considered as a factor guiding treatment in prostate cancer. The SUVmax value of 7.95 in the distinction of high-risk prostate cancer and the SUVmax value of 12.65 in the distinction of multimetastatic prostate cancer are safe parameters that can be used in daily practice. It will achieve more successful results with more standardized studies conducted on larger populations and will be used in a more standardized way in planning treatment.
