Journal article
68Ga-PSMA PET/CT compared with MRI/CT and diffusion-weighted MRI for primary lymph node staging prior to definitive radiotherapy in prostate cancer: a prospective diagnostic test accuracy study.
- Petersen LJ Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark. lajp@rn.dk.
- Nielsen JB Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
- Langkilde NC Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
- Petersen A Department of Pathology, Aalborg University Hospital, Aalborg, Denmark.
- Afshar-Oromieh A Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland.
- De Souza NM The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.
- De Paepe K The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.
- Fisker RV Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
- Arp DT Department of Medical Physics, Aalborg University Hospital, Aalborg, Denmark.
- Carl J Department of Medical Physics, Aalborg University Hospital, Aalborg, Denmark.
- Haberkorn U Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.
- Zacho HD Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
- 2019-06-14
Published in:
- World journal of urology. - 2020
English
BACKGROUND
The aim was to compare the diagnostic accuracy of 68Ga-PSMA PET/CT with conventional cross-sectional imaging and diffusion-weighted MRI (DW-MRI) for detecting lymph node metastasis (LNM) to stage prostate cancer patients. Twenty consecutive, newly- diagnosed prostate cancer patients were prospectively enrolled and underwent 68Ga-PSMA-11 PET/CT, anatomical MRI or contrast-enhanced CT, and DW-MRI prior to laparoscopic, template-based, extended lymph node dissection. Histopathological findings served as the reference test.
RESULTS
Histopathology showed LNM in 13 of 20 patients (19 high-risk, 1 intermediate risk). Five patients had metastasis-suspected lymph nodes on 68Ga-PSMA PET/CT. Patient-based analysis showed that the sensitivity and specificity for detecting LNM were 39% and 100% with 68Ga-PSMA PET/CT, 8% and 100% with MRI/CT, and 36% and 83% with DW-MRI, respectively. The positive and negative predictive values were 100% and 49% with 68Ga-PSMA PET/C, 100% and 37% with MRI/CT, and 80% and 42% with DW-MRI. Of 573 dissected lymph nodes, 33 were LNM from 26 regions. True-positive LNM on 68Ga-PSMA PET/CT was 9-11 mm in diameter, whereas false-negative LNM had a median diameter of 4 mm, with only 3 of 30 lymph nodes being larger than 10 mm. LNM were positive for PSMA by immunostaining.
CONCLUSIONS
The sensitivity of 68Ga-PSMA PET/CT was notably better than that of MRI/CT and comparable to that of DW-MRI. Some false positive findings with DW-MRI reduced its specificity and positive predictive value compared with those of 68Ga-PSMA PET/CT and MRI/CT.
The aim was to compare the diagnostic accuracy of 68Ga-PSMA PET/CT with conventional cross-sectional imaging and diffusion-weighted MRI (DW-MRI) for detecting lymph node metastasis (LNM) to stage prostate cancer patients. Twenty consecutive, newly- diagnosed prostate cancer patients were prospectively enrolled and underwent 68Ga-PSMA-11 PET/CT, anatomical MRI or contrast-enhanced CT, and DW-MRI prior to laparoscopic, template-based, extended lymph node dissection. Histopathological findings served as the reference test.
RESULTS
Histopathology showed LNM in 13 of 20 patients (19 high-risk, 1 intermediate risk). Five patients had metastasis-suspected lymph nodes on 68Ga-PSMA PET/CT. Patient-based analysis showed that the sensitivity and specificity for detecting LNM were 39% and 100% with 68Ga-PSMA PET/CT, 8% and 100% with MRI/CT, and 36% and 83% with DW-MRI, respectively. The positive and negative predictive values were 100% and 49% with 68Ga-PSMA PET/C, 100% and 37% with MRI/CT, and 80% and 42% with DW-MRI. Of 573 dissected lymph nodes, 33 were LNM from 26 regions. True-positive LNM on 68Ga-PSMA PET/CT was 9-11 mm in diameter, whereas false-negative LNM had a median diameter of 4 mm, with only 3 of 30 lymph nodes being larger than 10 mm. LNM were positive for PSMA by immunostaining.
CONCLUSIONS
The sensitivity of 68Ga-PSMA PET/CT was notably better than that of MRI/CT and comparable to that of DW-MRI. Some false positive findings with DW-MRI reduced its specificity and positive predictive value compared with those of 68Ga-PSMA PET/CT and MRI/CT.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00345-019-02846-z
- PMID 31190153
- Persistent URL
- https://sonar.ch/global/documents/178879
Statistics
Document views: 41
File downloads: