Artificial Intelligence for PET Image Reconstruction
| Autor: | Georg Schramm, Andrew J. Reader |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Biochemical recurrence
PET-CT medicine.medical_specialty business.industry Prostatectomy medicine.medical_treatment Urology Context (language use) urologic and male genital diseases law.invention Exact test Randomized controlled trial Artificial Intelligence Prostate Bed Paraaortic lymph nodes law Positron-Emission Tomography Image Processing Computer-Assisted Medicine Radiology Nuclear Medicine and imaging business |
| Zdroj: | Journal of Nuclear Medicine. 62:1330-1333 |
| ISSN: | 2159-662X 0161-5505 |
| Popis: | 1330 Objectives: 18F-fluciclovine and 68Ga-prostate-specific membrane antigen (PSMA) are PET radiotracers recommended for the localization of recurrent prostate cancer post-prostatectomy. We examined the positivity rates (planned secondary endpoint) of 18F-fluciclovine PET/CT and 68Ga-PSMA PET/CT in a randomized trial in patients with biochemical recurrence post-prostatectomy. Methods: The first 55 enrolled patients (accrual goal: 140) with detectable prostate-specific antigen (PSA) post-prostatectomy were randomized to undergo treatment planning based on either 18F-fluciclovine (mean dose: 9.85 ± 0.84 mCi) [Arm A] or 68Ga-PSMA (mean dose: 5.09 ± 0.15 mCi) with 20 mg Lasix given unless contraindicated [Arm B] in an ongoing prospective clinical trial. Two independent nuclear medicine physicians interpreted the PET scans by consensus. Final radiotherapy decisions were based on PET. Within the context of the trial, all lesions with abnormal radiotracer uptake, including equivocals, were treated as positive for recurrence unless proven as false positive. Positivity rates on 18F-fluciclovine and 68Ga-PSMA were compared on a whole body and region basis using chi-square or Fisher9s exact test. Results: Three patients dropped out before 18F-fluciclovine PET scanning; therefore, 52 patients were analyzed (26 patients in each arm). Median PSA was 0.28 ng/mL in the 18F-fluciclovine arm and 0.27 ng/mL in the 68Ga-PSMA arm. There was no significant difference in PSA (p = 0.96) and Gleason score at prostatectomy (p = 0.80) between groups. Nine patients had equivocal uptake in lesions: 3 prostate bed, 1 pelvic node, 1 paraaortic lymph node on 18F-fluciclovine, and 4 prostate bed on 68Ga-PSMA. No visceral lesion was detected with either modality. The overall positivity rate on 18F-fluciclovine was significantly higher than 68Ga-PSMA for whole body (96.2% vs 53.9%; p |
| Databáze: | OpenAIRE |
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