Diagnostic Accuracy of

Autor: Katharina, Sprute, Vasko, Kramer, Stefan A, Koerber, Manuel, Meneses, Rene, Fernandez, Cristian, Soza-Ried, Mathias, Eiber, Wolfgang A, Weber, Isabel, Rauscher, Kambiz, Rahbar, Michael, Schaefers, Tadashi, Watabe, Motohide, Uemura, Sadahiro, Naka, Norio, Nonomura, Jun, Hatazawa, Constantin, Schwab, Viktoria, Schütz, Markus, Hohenfellner, Tim, Holland-Letz, Juergen, Debus, Clemens, Kratochwil, Horacio, Amaral, Pete L, Choyke, Uwe, Haberkorn, Camilo, Sandoval, Frederik L, Giesel
Rok vydání: 2020
Předmět:
Zdroj: Journal of Nuclear Medicine
ISSN: 1535-5667
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