European journal of nuclear medicine and molecular imaging · 2026
Correlation of 68Ga-PSMA-11 PET/CT biodistribution with PSMA expression by immunohistochemistry in patients with HCC: A pilot prospective monocentric study.
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Vetrone L, Prosperi E, Prosperi E, Vasuri F, Degiovanni A, Allegri V, Castellucci P, Zanoni L, Nanni Cristina, Renzulli M, Lucidi V, Cattabriga A, Malizia C, Ravaioli M, Cescon M, Fanti S, Farolfi A
Аннотация
PURPOSE: Hepatocellular carcinoma (HCC) is a heterogeneous malignancy with limited diagnostic and prognostic tools beyond conventional imaging modalities such as CT and ceMRI. Prostate-specific membrane antigen (PSMA) expression, observed in the neoangiogenic endothelial cells of HCC, has emerged as a potential target. This study evaluated the correlation between PSMA biodistribution using [68Ga]Ga-PSMA-11 positron emission tomography (PSMA PET/CT) and PSMA expression by immunohistochemistry (IHC) in surgical HCC patients. Secondary aim was to assess the diagnostic performance of PSMA PET/CT in this prospective cohort.
METHODS: This prospective monocentric study enrolled patients with suspected HCC undergoing curative-intent liver resection or transplantation. All participants underwent ceMRI and [68Ga]Ga-PSMA-11 PET/CT within a 3-month interval, with imaging results correlated to postoperative histopathology and IHC for PSMA expression. Semi-quantitative PET parameters were analyzed alongside tumor grade, vascular invasion, and IHC metrics.
RESULTS: Eligible patients were 39, of those 31 were treated surgically. 27/31 (87%) showed PSMA uptake on PET/CT, with a median SUVmax of 12.6 (IQR10.2-16.5). According to IHC intensity analysis, PSMA was expressed in 22/24 (91.6%) of HCC. High PSMA uptake correlated with strong PSMA expression in tumor-associated vasculature (p = 0.028). No significant correlations were found between PET parameters and histological features, such as Edmondson grade or vascular invasion (p > 0.05).
CONCLUSIONS: PSMA PET/CT offers robust diagnostic accuracy for HCC and correlates with vascular PSMA expression, suggesting potential utility in preoperative staging. These findings support the further exploration of PSMA imaging as a biomarker for HCC.
METHODS: This prospective monocentric study enrolled patients with suspected HCC undergoing curative-intent liver resection or transplantation. All participants underwent ceMRI and [68Ga]Ga-PSMA-11 PET/CT within a 3-month interval, with imaging results correlated to postoperative histopathology and IHC for PSMA expression. Semi-quantitative PET parameters were analyzed alongside tumor grade, vascular invasion, and IHC metrics.
RESULTS: Eligible patients were 39, of those 31 were treated surgically. 27/31 (87%) showed PSMA uptake on PET/CT, with a median SUVmax of 12.6 (IQR10.2-16.5). According to IHC intensity analysis, PSMA was expressed in 22/24 (91.6%) of HCC. High PSMA uptake correlated with strong PSMA expression in tumor-associated vasculature (p = 0.028). No significant correlations were found between PET parameters and histological features, such as Edmondson grade or vascular invasion (p > 0.05).
CONCLUSIONS: PSMA PET/CT offers robust diagnostic accuracy for HCC and correlates with vascular PSMA expression, suggesting potential utility in preoperative staging. These findings support the further exploration of PSMA imaging as a biomarker for HCC.