Mengxia Chen1, Qing Zhang1, Chengwei Zhang1, Xiaozhi Zhao1, Giancarlo Marra2, Jie Gao1, Xiaoyu Lv1, Bing Zhang3, Yao Fu4, Feng Wang5, Xuefeng Qiu6, Hongqian Guo6. 1. Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Jiangsu, China. 2. Department of Urology, San Glovanni Battista Hospital, Città della Salute Scienza and University of Turin, Turin, Italy. 3. Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. 4. Department of Pathology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China; and. 5. Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. 6. Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Jiangsu, China dr.ghq@nju.edu.cn Xuefeng_Qiu@163.com.
Abstract
Our purpose was to explore whether 68Ga-PSMA PET/CT alone (PET/CT) or in combination with multiparametric MRI (PET/MRI) can improve the detection of clinically significant prostate cancer (PCa). Methods: We retrospectively enrolled 54 patients who underwent both MRI and PET/CT before radical prostatectomy. Regions of interest on MR images, PET/CT images, and pathologic images were marked. A lesion was defined as a region of interest marked on images obtained with any of the 3 modalities. All lesions were characterized using the prostate imaging reporting and data system (PI-RADS), the molecular imaging PSMA expression score, and the pathologic results and analyzed. Diagnostic performance was analyzed by receiver-operating-characteristic analysis. Specific improvement for lesions with different PI-RADS scores was analyzed using the net reclassification index (NRI). Results: In total, 90 lesions from 54 patients were analyzed, among which 66 lesions represented clinically significant PCa. Receiver-operating-characteristic analysis showed PET/MRI to perform better than MRI in detecting clinically significant PCa (change in area under the curve, 0.06; 95% confidence interval, 0.01-0.12; P < 0.05). With the calculated cutoff, PET/MRI performed significantly better than MRI (NRI, 21.9%; P < 0.01), with an improvement in sensitivity (89% vs. 76%, P < 0.01) at no sacrifice of specificity (96% vs. 88%, P > 0.05). Improvement in diagnosing clinically significant PCa occurred for lesions classified as PI-RADS 3 (NRI, 66.7%; P < 0.01). Conclusion: PET/MRI improves the detection of clinically significant PCa for PI-RADS 3 lesions.
Our purpose was to explore whether 68Ga-PSMA PET/CT alone (PET/CT) or in combination with multiparametric MRI (PET/MRI) can improve the detection of clinically significant prostate cancer (PCa). Methods: We retrospectively enrolled 54 patients who underwent both MRI and PET/CT before radical prostatectomy. Regions of interest on MR images, PET/CT images, and pathologic images were marked. A lesion was defined as a region of interest marked on images obtained with any of the 3 modalities. All lesions were characterized using the prostate imaging reporting and data system (PI-RADS), the molecular imaging PSMA expression score, and the pathologic results and analyzed. Diagnostic performance was analyzed by receiver-operating-characteristic analysis. Specific improvement for lesions with different PI-RADS scores was analyzed using the net reclassification index (NRI). Results: In total, 90 lesions from 54 patients were analyzed, among which 66 lesions represented clinically significant PCa. Receiver-operating-characteristic analysis showed PET/MRI to perform better than MRI in detecting clinically significant PCa (change in area under the curve, 0.06; 95% confidence interval, 0.01-0.12; P < 0.05). With the calculated cutoff, PET/MRI performed significantly better than MRI (NRI, 21.9%; P < 0.01), with an improvement in sensitivity (89% vs. 76%, P < 0.01) at no sacrifice of specificity (96% vs. 88%, P > 0.05). Improvement in diagnosing clinically significant PCa occurred for lesions classified as PI-RADS 3 (NRI, 66.7%; P < 0.01). Conclusion: PET/MRI improves the detection of clinically significant PCa for PI-RADS 3 lesions.
Authors: Tessa S S Genders; Sandra Spronk; Theo Stijnen; Ewout W Steyerberg; Emmanuel Lesaffre; M G Myriam Hunink Journal: Radiology Date: 2012-10-23 Impact factor: 11.105
Authors: Stacy Loeb; Marc A Bjurlin; Joseph Nicholson; Teuvo L Tammela; David F Penson; H Ballentine Carter; Peter Carroll; Ruth Etzioni Journal: Eur Urol Date: 2014-01-09 Impact factor: 20.096
Authors: Osamu Ukimura; Jonathan A Coleman; Alex de la Taille; Mark Emberton; Jonathan I Epstein; Stephen J Freedland; Gianluca Giannarini; Adam S Kibel; Rodolfo Montironi; Guillaume Ploussard; Monique J Roobol; Vincenzo Scattoni; J Stephen Jones Journal: Eur Urol Date: 2012-09-25 Impact factor: 20.096
Authors: Guillaume Ploussard; Jonathan I Epstein; Rodolfo Montironi; Peter R Carroll; Manfred Wirth; Marc-Oliver Grimm; Anders S Bjartell; Francesco Montorsi; Stephen J Freedland; Andreas Erbersdobler; Theodorus H van der Kwast Journal: Eur Urol Date: 2011-05-17 Impact factor: 20.096
Authors: Caroline M A Hoeks; Martijn G Schouten; Joyce G R Bomers; Stefan P Hoogendoorn; Christina A Hulsbergen-van de Kaa; Thomas Hambrock; Henk Vergunst; J P Michiel Sedelaar; Jurgen J Fütterer; Jelle O Barentsz Journal: Eur Urol Date: 2012-02-01 Impact factor: 20.096
Authors: Ali Afshar-Oromieh; Christian M Zechmann; Anna Malcher; Matthias Eder; Michael Eisenhut; Heinz G Linhart; Tim Holland-Letz; Boris A Hadaschik; Frederik L Giesel; Jürgen Debus; Uwe Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2013-09-27 Impact factor: 9.236
Authors: Chen Liu; Teli Liu; Zhongyi Zhang; Ning Zhang; Peng Du; Yong Yang; Yiqiang Liu; Wei Yu; Nan Li; Michael A Gorin; Steven P Rowe; Hua Zhu; Kun Yan; Zhi Yang Journal: J Nucl Med Date: 2020-02-07 Impact factor: 10.057
Authors: Ida Sonni; Ely R Felker; Andrew T Lenis; Anthony E Sisk; Shadfar Bahri; Martin Allen-Auerbach; Wesley R Armstrong; Voraparee Suvannarerg; Teeravut Tubtawee; Tristan Grogan; David Elashoff; Matthias Eiber; Steven S Raman; Johannes Czernin; Robert E Reiter; Jeremie Calais Journal: J Nucl Med Date: 2021-10-14 Impact factor: 11.082
Authors: Simon Spohn; Chiara Jaegle; Thomas F Fassbender; Tanja Sprave; Eleni Gkika; Nils H Nicolay; Michael Bock; Juri Ruf; Matthias Benndorf; Christian Gratzke; Anca L Grosu; Constantinos Zamboglou Journal: Eur J Nucl Med Mol Imaging Date: 2020-04-28 Impact factor: 9.236
Authors: Dejan Kostyszyn; Tobias Fechter; Nico Bartl; Anca L Grosu; Christian Gratzke; August Sigle; Michael Mix; Juri Ruf; Thomas F Fassbender; Selina Kiefer; Alisa S Bettermann; Nils H Nicolay; Simon Spohn; Maria U Kramer; Peter Bronsert; Hongqian Guo; Xuefeng Qiu; Feng Wang; Christoph Henkenberens; Rudolf A Werner; Dimos Baltas; Philipp T Meyer; Thorsten Derlin; Mengxia Chen; Constantinos Zamboglou Journal: J Nucl Med Date: 2020-10-30 Impact factor: 10.057