68 Ga-PSMA-PET/CT in comparison with 18 F-fluoride-PET/CT and whole-body MRI for the detection of bone metastases in patients with prostate cancer: a prospective diagnostic accuracy study.

Autor: Dyrberg E; Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev Ringvej 75, DK-2730, Herlev, Denmark. edyrberg@hotmail.com.; Department of Clinical Physiology and Nuclear Medicine, PET and Cyclotron, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark. edyrberg@hotmail.com., Hendel HW; Department of Clinical Physiology and Nuclear Medicine, PET and Cyclotron, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark., Huynh THV; Department of Clinical Physiology and Nuclear Medicine, PET and Cyclotron, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark., Klausen TW; Department of Hematology, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark., Løgager VB; Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev Ringvej 75, DK-2730, Herlev, Denmark., Madsen C; Department of Clinical Physiology and Nuclear Medicine, PET and Cyclotron, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark., Pedersen EM; Department of Radiology, Aarhus University Hospital, DK-8000, Aarhus C, Denmark., Pedersen M; Department of Clinical Physiology and Nuclear Medicine, PET and Cyclotron, Copenhagen University Hospital Herlev and Gentofte, DK-2730, Herlev, Denmark., Thomsen HS; Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev Ringvej 75, DK-2730, Herlev, Denmark.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2019 Mar; Vol. 29 (3), pp. 1221-1230. Date of Electronic Publication: 2018 Aug 21.
DOI: 10.1007/s00330-018-5682-x
Abstrakt: Objectives: To determine the diagnostic accuracy of 68 gallium prostate-specific membrane antigen (PSMA)-based positron emission tomography/computed tomography (PET/CT) in comparison with 18 F-fluoride-based PET/CT (NaF-PET/CT) and whole-body magnetic resonance imaging (WB-MRI) for the detection of bone metastases in patients with prostate cancer.
Methods: Sixty patients with prostate cancer were included in the period May 2016 to June 2017. The participants underwent three scans (index tests) within 30 days: a NaF-PET/CT, a WB-MRI and a PSMA-PET/CT. Experienced specialists assessed the scans. In the absence of a histological reference standard, the final diagnosis was determined as a panel diagnosis. Measures of the diagnostic performances of the index tests were calculated from patient-based dichotomous outcomes (0 or ≥ 1 bone metastasis) and pairwise compared (McNemar test). For each index test, the agreement with the final diagnosis with regard to the number of bone metastases detected (0, 1-5, > 5) and the inter-reader agreement was calculated (kappa coefficients).
Results: Fifty-five patients constituted the final study population; 20 patients (36%) were classified as having bone metastatic disease as their final diagnosis. The patient-based diagnostic performances were (sensitivity, specificity, overall accuracy) PSMA-PET/CT (100%, 100%, 100%), NaF-PET/CT (95%, 97%, 96%) and WB-MRI (80%, 83%, 82%). The overall accuracy of PSMA-PET/CT was significantly more favourable compared to WB-MRI (p = 0.004), but not to NaF-PET/CT (p = 0.48). PSMA-PET/CT classified the number of bone metastases reliably compared to the final diagnosis (kappa coefficient 0.97) and with an "almost perfect" inter-reader agreement (kappa coefficient 0.93).
Conclusions: The overall accuracy of PSMA-PET/CT was significantly more advantageous compared to WB-MRI, but not to NaF-PET/CT.
Key Points: • PSMA-PET/CT assessed the presence of bone metastases correctly in all 55 patients • PSMA-PET/CT was more advantageous compared to WB-MRI • No difference was found between PSMA-PET/CT and NaF-PET/CT.
Databáze: MEDLINE
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