The value of 18F-PSMA-1007 PET/CT in preoperative evaluation of prostate cancer within PSA gray area

18F-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography/computed tomograpy (PET/CT) had been increasingly significant in detecting prostate cancer. This study was aimed to assess the usefulness of 18F-PSMA-1007 PET/CT in preoperative evaluation of prostate cancer for the cases with serum total prostate-specific antigen (tPSA) levels between 4 and 10 ng/mL, referred as the PSA gray area. A total of 117 prostate cancer patients in PSA gray area were retrospectively analyzed in the period between March 2019 and December 2022. The independent predictors of extraprostatic extension (EPE) were identified via the Univariate and multivariate analyses. The maximum standardized uptake value (SUVmax) was the only independent predictor of EPE odds ratio (OR), 1.114; 95% confidence interval (CI), 1.040–1.194; p = 0.002). The predicted model’s area under receiver-operating characteristic curves was 75.4%. The sensitivity, specificity and accuracy of 18F-PSMA-1007 PET/CT were calculated for diagnosing the regional lymph node and bone metastases, and obtained as 85.71%, 99.20%, 99.05% and 100%, 97.35%, 99.15%, respectively. In conclusion, SUVmax as compared to the clinical parameters had higher predictive value for EPE in prostate cancer patients within PSA gray area. 18F-PSMA-1007 PET/CT had thus the satisfactory evaluation efficacy for diagnosing the regional lymph node and bone metastases.