Diagnostic Accuracy of 18F-PSMA-1007 PET/CT Imaging for Lymph Node Staging of Prostate Carcinoma in Primary and Biochemical Recurrence
| Autor: | Clemens Kratochwil, Horacio Amaral, Camilo Sandoval, Frederik L. Giesel, Markus Hohenfellner, Katharina Sprute, M. Eiber, Norio Nonomura, Sadahiro Naka, Manuel Meneses, Jun Hatazawa, Viktoria Schütz, Tim Holland-Letz, Michael Schaefers, P. L. Choyke, Uwe Haberkorn, Juergen Debus, Cristian Soza-Ried, René Fernández, Vasko Kramer, Tadashi Watabe, Constantin Schwab, Kambiz Rahbar, Motohide Uemura, Isabel Rauscher, Stefan A. Koerber, Wolfgang Weber |
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| Rok vydání: | 2020 |
| Předmět: |
Biochemical recurrence
medicine.medical_specialty business.industry Prostatectomy medicine.medical_treatment urologic and male genital diseases medicine.disease 030218 nuclear medicine & medical imaging Lesion 03 medical and health sciences Prostate cancer 0302 clinical medicine 030220 oncology & carcinogenesis medicine Radiology Nuclear Medicine and imaging Lymphadenectomy Histopathology Radiology Lymph Stage (cooking) medicine.symptom business |
| Zdroj: | Journal of Nuclear Medicine. 62:208-213 |
| ISSN: | 2159-662X 0161-5505 |
| Popis: | Prostate-specific membrane antigen (PSMA)-ligand PET/CT is performed on patients with prostate cancer to stage the disease initially or to identify sites of recurrence after definitive therapy. On the basis of clinical results, 18F-PSMA-1007 is a promising PSMA PET tracer, but detailed histologic confirmation has been lacking. Methods: Ninety-six patients with prostate cancer underwent 18F-PSMA-1007 PET/CT followed by either radical prostatectomy with lymphadenectomy or salvage lymphadenectomy. The histologic findings of PSMA PET-positive nodes were analyzed retrospectively. A lesion-based and patient-based analysis was performed comparing all positive lesions and only lesions larger than 3 mm on histopathology. Results: Of the patients, 90.6% received 18F-PSMA-1007 PET/CT for staging before the primary treatment, whereas 9.4% underwent imaging for biochemical recurrence. In 34.4% of the cohort, positive lymph nodes were present on imaging. In total, 1,746 lymph nodes were dissected in 96 patients. 18F-PSMA-1007 PET had a lesion-based sensitivity of 81.7%, a specificity of 99.6%, a positive predictive value of 92.4%, and a negative predictive value of 98.9% for detecting positive lymph nodes larger than 3 mm. In the analysis of all malignant nodes regardless of size, the overall sensitivity, specificity, positive predictive value, and negative predictive value on lesion-based analysis were 71.2%, 99.5%, 91.3%, and 97.9%, respectively. The patient-based analysis showed a sensitivity of 85.9% and a specificity of 99.5% for lymph nodes larger than 3 mm. Conclusion:18F-PSMA-1007 PET/CT reliably detects malignant lymph nodes and has an exceptional specificity of more than 99% for nodal metastases. |
| Databáze: | OpenAIRE |
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