Kambiz Rahbar1, Matthias Weckesser2, Sebastian Huss3, Axel Semjonow4, Hans-Jörg Breyholz2, Andres J Schrader4, Michael Schäfers5, Martin Bögemann4. 1. Department of Nuclear Medicine, University Hospital Muenster, Muenster, Germany rahbar@uni-muenster.de. 2. Department of Nuclear Medicine, University Hospital Muenster, Muenster, Germany. 3. Gerhard Domagk Institute of Pathology, University Hospital Muenster, Muenster, Germany. 4. Prostate Center, Department for Urology, University Hospital Muenster, Muenster, Germany. 5. Department of Nuclear Medicine, University Hospital Muenster, Muenster, Germany European Institute for Molecular Imaging, University of Muenster, Muenster, Germany; and Cells-in-Motion Cluster of Excellence, University of Muenster, Muenster, Germany.
Abstract
UNLABELLED: We evaluated the diagnostic value and accuracy of prostate-specific membrane antigen (PSMA) PET for the intraprostatic delineation of prostate cancer before prostatectomy. METHODS: We identified 6 patients with biopsy-proven high-risk prostate cancer who were referred for (68)Ga-PSMA PET/CT before radical prostatectomy to rule out metastasis. After prostatectomy, a histologic map of the prostate was reconstructed. The histologic extent and Gleason score of each segment of the prostate were compared with (68)Ga-PSMA PET images resliced to the histologic axis. Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios were calculated. The SUV of each segment was measured, and median values were compared. RESULTS: Of the 132 segments, 112 were eligible for analysis. The correlation of histologic results with (68)Ga-PSMA PET images showed a specificity and sensitivity of 92%. The positive and negative likelihood ratio and the positive and negative predictive value for detection of prostate cancer on (68)Ga-PSMA PET were 11.5, 0.09, 96%, and 85%, respectively. The median SUVmax of true-positive prostate segments was significantly higher than that of true-negative segments (11.0 ± 7.8 vs. 2.7 ± 0.9, P< 0.001), and a cutoff of 4 revealed a sensitivity and specificity of 86.5% and an accuracy of 87.5%. CONCLUSION: These preliminary results show that the intraprostatic localization and extent of prostate cancer may be estimated by (68)Ga-PSMA PET. This imaging method may be helpful for identifying target lesions before prostate biopsy and may support decision making before focal or radical therapy.
UNLABELLED: We evaluated the diagnostic value and accuracy of prostate-specific membrane antigen (PSMA) PET for the intraprostatic delineation of prostate cancer before prostatectomy. METHODS: We identified 6 patients with biopsy-proven high-risk prostate cancer who were referred for (68)Ga-PSMA PET/CT before radical prostatectomy to rule out metastasis. After prostatectomy, a histologic map of the prostate was reconstructed. The histologic extent and Gleason score of each segment of the prostate were compared with (68)Ga-PSMA PET images resliced to the histologic axis. Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios were calculated. The SUV of each segment was measured, and median values were compared. RESULTS: Of the 132 segments, 112 were eligible for analysis. The correlation of histologic results with (68)Ga-PSMA PET images showed a specificity and sensitivity of 92%. The positive and negative likelihood ratio and the positive and negative predictive value for detection of prostate cancer on (68)Ga-PSMA PET were 11.5, 0.09, 96%, and 85%, respectively. The median SUVmax of true-positive prostate segments was significantly higher than that of true-negative segments (11.0 ± 7.8 vs. 2.7 ± 0.9, P< 0.001), and a cutoff of 4 revealed a sensitivity and specificity of 86.5% and an accuracy of 87.5%. CONCLUSION: These preliminary results show that the intraprostatic localization and extent of prostate cancer may be estimated by (68)Ga-PSMA PET. This imaging method may be helpful for identifying target lesions before prostate biopsy and may support decision making before focal or radical therapy.
Authors: Kambiz Rahbar; Ali Afshar-Oromieh; Martin Bögemann; Stefan Wagner; Michael Schäfers; Lars Stegger; Matthias Weckesser Journal: Eur J Nucl Med Mol Imaging Date: 2018-03-14 Impact factor: 9.236
Authors: Andrei Gafita; Marie Bieth; Markus Krönke; Giles Tetteh; Fernando Navarro; Hui Wang; Elisabeth Günther; Bjoern Menze; Wolfgang A Weber; Matthias Eiber Journal: J Nucl Med Date: 2019-03-08 Impact factor: 10.057
Authors: Lena Thomas; Steffi Kantz; Arthur Hung; Debra Monaco; Florian C Gaertner; Markus Essler; Holger Strunk; Wolfram Laub; Ralph A Bundschuh Journal: Eur J Nucl Med Mol Imaging Date: 2018-02-21 Impact factor: 9.236
Authors: Cordula A Jilg; Vanessa Drendel; H Christian Rischke; Teresa I Beck; Kathrin Reichel; Malte Krönig; Ulrich Wetterauer; Wolfgang Schultze-Seemann; Philipp T Meyer; Werner Vach Journal: J Nucl Med Date: 2019-01-25 Impact factor: 10.057