Clinical, Pathologic, and Imaging Variables Associated with Prostate Cancer Detection by PSMA PET/CT and Multiparametric MRI.

Autor:	Sonni I; Department of Radiological Sciences, UCLA, Los Angeles, California; isonni@mednet.ucla.edu.; Department of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy., Weiner AB; Department of Urology, UCLA, Los Angeles, California.; Institute for Precision Health, UCLA, Los Angeles, California., Doddipalli S; Department of Radiological Sciences, UCLA, Los Angeles, California., Deol M; Department of Radiological Sciences, UCLA, Los Angeles, California., Ban D; Department of Radiological Sciences, UCLA, Los Angeles, California., Kim HO; Department of Radiological Sciences, UCLA, Los Angeles, California., Grogan T; Department of Medicine Statistics Core, UCLA, Los Angeles, California., Ahuja P; Department of Radiological Sciences, UCLA, Los Angeles, California., Barroso N; Department of Radiological Sciences, UCLA, Los Angeles, California., Zong Y; Department of Pathology, UCLA, Los Angeles, California; and., Soin P; Department of Pathology, UCLA, Los Angeles, California; and., Sisk A; Department of Pathology, UCLA, Los Angeles, California; and., Czernin J; Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California., Hsu W; Department of Radiological Sciences, UCLA, Los Angeles, California., Calais J; Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California., Reiter RE; Department of Urology, UCLA, Los Angeles, California., Raman SS; Department of Radiological Sciences, UCLA, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2024 Dec 03; Vol. 65 (12), pp. 1923-1931. Date of Electronic Publication: 2024 Dec 03.
DOI:	10.2967/jnumed.124.268443
Abstrakt:	Multiparametric MRI (mpMRI) and prostate-specific membrane antigen (PSMA) PET/CT are complementary imaging modalities used in the presurgical evaluation of patients with prostate cancer (PCa). The purpose of this study was to characterize clinically significant PCa (csPCa) detected and not detected by PSMA PET/CT and mpMRI, focusing on tumors detected solely by PSMA PET/CT and overlooked by mpMRI. Methods: We conducted a single-center, retrospective analysis of patients who underwent both PSMA PET/CT and mpMRI within 3 mo of each other and before radical prostatectomy. Two nuclear medicine physicians and 2 radiologists, in a masked manner, independently contoured PCa lesions on PSMA PET/CT and mpMRI, respectively. A consensus read was done with a third reader for each modality, and a majority rule was applied (2:1). After centralized imaging, a pathologic review was done by a genitourinary pathologist. We assessed agreement between imaging modalities and correlation with pathology. Logistic regression models explored associations between clinicopathologic variables and tumor detection on imaging. Results: In total, 132 csPCa tumors from 100 patients were identified on surgical pathology. PSMA PET/CT showed higher lesion-level (87% vs. 80%) and patient-level (98% vs. 94%) sensitivity than mpMRI. Tumors detected on both imaging modalities were larger and had higher grade groups than those not detected by one or both imaging modalities. On multivariable analysis, csPCa tumors undetected by mpMRI but detected by PSMA PET/CT were smaller than those detected by both modalities. Most tumors showing aggressive pathologic features, such as the large cribriform pattern (94.7%) and the intraductal carcinoma (96%), were correctly detected by both imaging modalities. Limitations included selection bias in a surgical cohort. Conclusion: PSMA PET/CT tends to detect smaller csPCa not detected by mpMRI. Larger tumors on pathology with higher grade groups are more likely to be correctly detected by both imaging modalities. These findings provide insights for refining presurgical evaluation strategies in PCa. (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
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