Hello All , from a previous post : The SUVmax can discriminate PCA metastasis degree & oligo-metastasis status. The ADT treated oligo-metastasis patient may still have disease progression when the primary prostatic carcinoma focus SUVmax is greater than 28.22 . This was sourced from Frontiers in Oncology 26 Aug. 2022 .
I am Oligo-Met with one tumor in 1 lymph node in my pelvic region . The report from the PSMA-pet pylarify said that tumor was SUVmax 24 . I had SBRT , 3 fraction to that tumor and 25 fractions to the entire pelvic field . I asked the MO at V. A. and she really didnt say much about that . So my SUV max is at 24 . Can I expect progression ? Can someone here explain the meaning behind SUVmax ? Thanks
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reconjj
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It is impossible to tell if you will have progress. I believe there are several factors here including whether the tumor had extra prostatic extension. From reviewing what you have done, I do not believe there was much more that you could have done...
SUV max is the maximum standardized uptake value for the diagnostic agent involved in searching for a cancer. This is the maximum concentration of the diagnostic agent in the tissues, bones, organs, etc.... The diagnostic agent could be FDG, Axumin, Pylarify, etc...
Progression or cure would just be a guess. Potentially, you could be cured. It is those darn micrometastatic cells that are the real question. Just gonna have to wait it out and see...
Yep it will be a wait and see . According to that study 28.22 or more was the marker for progression . I hope that bullet dont have my name on it . Thank You
As far as I know, higher SUVmax has been characterized as predictive only of potentially better response to radioligand therapy (Pluvicto, etc). No real predictive value wrt progression, that I’m aware of.
From a quick read of the methods (a retrospective study) and conclusions in this article, I’m left with a bit of ambiguity b/w causation and correlation. This in particular:
The SUVmax can discriminate PCa metastasis degree and oligo-metastasis status.
That’s not what SUVmax measures. Regardless, I saw no hypothesis around how SUV uptake could be causal (or associated with something causal) for metastasis degree.
I’d frankly agree with Don that there’s no way to determine if one will have progression, or to what degree, or when, or … etc.
Personally I would welcome an SUV at your 24, the article’s 28 cutoff, or even the 32 that I currently have — since RLT may well be in my future. Regardless, my met burden is decreasing (as per scans) over the last 10 months, even with my 32 SUVmax…proving nothing, actually. Again, causation vs correlation.
As an aside, you might be interested in what Beall’s List and Wikipedia have to say about the Frontiers In journal collection:
Beall’s list has some value as a start point, but it’s not gospel.
As far as Frontiers Media, I notice that inclusion in Beall’s list was not the only controversy. I don’t draw any absolute conclusions about either Beall’s or Frontier…all of this just points to the value of healthy skepticism.
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ADT vacation versus Continuous
