68 Ga-PSMA PET/CT vs. mpMRI for locoregional prostate cancer staging: correlation with final histopathology.

Autor: Berger I; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia. israel.berger@sydney.edu.au.; University of Sydney, Sydney, NSW, Australia. israel.berger@sydney.edu.au., Annabattula C; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia.; Department of Medical Imaging, Nepean Hospital, Penrith, NSW, Australia., Lewis J; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Shetty DV; Department of Medical Imaging, Nepean Hospital, Penrith, NSW, Australia., Kam J; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Maclean F; Douglass Hanly Moir Pathology, North Ryde, NSW, Australia., Arianayagam M; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Canagasingham B; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Ferguson R; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Khadra M; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia.; University of Sydney, Sydney, NSW, Australia., Ko R; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Winter M; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia., Loh H; Department of Medical Imaging, Nepean Hospital, Penrith, NSW, Australia., Varol C; Nepean Urology Research Group, Nepean Hospital, Penrith, NSW, Australia.
Jazyk: angličtina
Zdroj: Prostate cancer and prostatic diseases [Prostate Cancer Prostatic Dis] 2018 Jun; Vol. 21 (2), pp. 204-211. Date of Electronic Publication: 2018 Jun 01.
DOI: 10.1038/s41391-018-0048-7
Abstrakt: Background: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) can be used to locate lesions based on PSMA avidity, however guidelines on its use are limited by its infancy. We aimed to compare multiparametric magnetic resonance imaging (mpMRI) and PSMA PET/CT to prostatectomy histopathology.
Methods: We conducted a chart review from February 2015 to January 2017 of 50 male patients staged for prostate cancer using PSMA PET/CT and mpMRI who then underwent radical prostatectomy. Pre-operative PSMA PET/CT and mpMRI were paired with corresponding histopathology. Correlations, sensitivity, and specificity were used for comparisons.
Results: A total of 81 lesions were confirmed by histopathology. Fifty index lesions were detected by histopathology, all of which were detected by PSMA PET/CT (100% detection), and 47 by mpMRI (94% detection). Thirty-one histologically confirmed secondary lesions were detected, 29 of which were detected by PSMA PET/CT (93.5% detection), and 16 by mpMRI (51.6% detection). PSMA had better sensitivity for index lesion localization than mpMRI (81.1 vs. 64.8%). Specificity was similar for PSMA PET/CT and mpMRI (84.6 vs. 82.7%). SUV max of index lesions ranged from 2.9 to 39.6 (M = 9.27 ± 6.41). Index lesion SUV max was positively correlated with PSA (rho = 0.48, p < 0.001) and ISUP grade (rho = 0.51, p < 0.001).
Conclusions: PSMA-PET/CT provided superior detection of prostate cancer lesions with better sensitivity than mpMRI. PSMA-PET/CT can be used to enhance locoregional mpMRI to provide improved detection and characterization of lesions.
Databáze: MEDLINE
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