Value of 68Ga-PSMA HBED-CC PET for the Assessment of Lymph Node Metastases in Prostate Cancer Patients with Biochemical Recurrence: Comparison with Histopathology After Salvage Lymphadenectomy

Autor: Ambros J. Beer, Markus Schwaiger, Tobias Maurer, Juergen E. Gschwend, Frank-Philipp Graner, Bernhard Haller, Gregor Weirich, Isabel Rauscher, Alan Doherty, Matthias Eiber
Rok vydání: 2016
Předmět:
Biochemical recurrence
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Biopsy
Salvage therapy
Gallium Radioisotopes
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
03 medical and health sciences
Prostate cancer
0302 clinical medicine
medicine
Organometallic Compounds
Humans
Radiology
Nuclear Medicine and imaging

Lymph node
Edetic Acid
Gallium Isotopes
Aged
Retrospective Studies
Salvage Therapy
medicine.diagnostic_test
business.industry
Prostatic Neoplasms
Reproducibility of Results
Magnetic resonance imaging
Middle Aged
medicine.disease
medicine.anatomical_structure
Treatment Outcome
Positron emission tomography
030220 oncology & carcinogenesis
Lymphatic Metastasis
Positron-Emission Tomography
Lymph Node Excision
Histopathology
Lymphadenectomy
Radiology
Lymph Nodes
Neoplasm Recurrence
Local

Radiopharmaceuticals
business
Oligopeptides
Zdroj: Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 57(11)
ISSN: 1535-5667
Popis: The purpose of this study was to evaluate the accuracy of Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)] PET compared with morphologic imaging for the assessment of lymph node metastases (LNM) in patients with recurrent prostate cancer. Methods: Forty-eight patients (median age, 71 y; interquartile range, 66–74 y) with biochemical recurrence (median prostate-specific antigen level, 1.31 ng/mL; interquartile range, 0.75–2.55 ng/mL) who underwent 68Ga–prostate-specific membrane antigen (PSMA) HBED-CC PET/CT or PET/MR and salvage lymphadenectomy were retrospectively included. Institutional review board approval and written informed consent were obtained from all patients for the purpose of anonymized evaluation and publication of their data. Standardized predefined lymph node (LN) template fields (n = 10) were evaluated in 68Ga-PSMA HBED-CC PET and morphologic imaging for the presence of LNM using a 5-point-scale. Additionally, SUVmean/max and size of suspicious lesions were determined. Specificity of 68Ga-PSMA HBED-CC PET imaging for PET-positive LNs was defined by comparison to histopathology. The diagnostic accuracy of 68Ga-PSMA HBED-CC PET compared with morphologic imaging alone was assessed, and areas under the receiver-operating-characteristic curves are presented. Results: LNM were found histologically in 68 of 179 resected anatomic LN fields (38.0%). The specificity of 68Ga-PSMA HBED-CC PET and morphologic imaging was 97.3% and 99.1%, respectively. However, 68Ga-PSMA HBED-CC PET detected LNM in 53 of 68 histopathologically proven metastatic LN fields (77.9%) whereas morphologic imaging was positive in only 18 of 67 (26.9%). 68Ga-PSMA HBED-CC PET imaging performed significantly superior to morphologic imaging for detection of LNM (difference in the areas under the receiver-operating-characteristic curves, 0.139; 95% confidence interval, 0.063–0.214; P
Databáze: OpenAIRE