Abstract
Our purpose was to evaluate the association of a new biochemical recurrence (BCR) risk stratification system with PSMA-targeted PET/CT findings. Methods: Two prospective studies that included patients with BCR were pooled. Findings on PSMA PET were catalogued. Patients were characterized according to the European Association of Urology BCR risk categories. Univariable and multivariable analyses were performed by logistic regression. Results: In total, 145 patients were included (45 low-risk and 100 high-risk). High-risk BCR patients had a higher positive rate than low-risk patients (82.0% vs. 48.9%; P < 0.001) and reached independent predictor status for positive PSMA PET/CT scan results on multivariable logistic regression (odds ratio, 6.73; 95% CI, 2.41-18.76; P < 0.001). The area under the curve using the combination of BCR risk group and prostate-specific antigen was higher than that using prostate-specific antigen alone (0.834 vs. 0.759, P = 0.015). Conclusion: The European Association of Urology BCR risk groups define the candidates who can most benefit from a PSMA PET/CT scan when BCR occurs.