Snir Dekalo1, Jonathan Kuten2, Nicola J Mabjeesh3, Avi Beri3, Einat Even-Sapir2, Ofer Yossepowitch3. 1. Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler School Of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel. Electronic address: snirdekalo@gmail.com. 2. Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Sackler School Of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel. 3. Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler School Of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.
Abstract
INTRODUCTION: Data on the accuracy of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with intermediate/high-risk prostate cancer are being accumulated. Its role in assessing the extent of local disease has not been fully elaborated. AIM: To determine the performance characteristics of 68Ga-PSMA PET/CT in identifying local disease extension in patients with intermediate/high risk prostate cancer. METHODS: 68Ga-PSMA PET/CT studies of 61 consecutive patients with intermediate/high-risk prostate cancer who underwent radical prostatectomy were reviewed by nuclear medicine specialists. Tumor location, extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph nodes involvement (LNI) were compared to pathological findings. The incremental value of 68Ga-PSMA PET/CT to established nomograms was determined. RESULTS: Two patients without pathologic uptake of 68Ga-PSMA were excluded. Seventeen patients were diagnosed with EPE (29%), 12(20%) had SVI and 3(5%) LNI. The concordance between tumor location and 68Ga-PSMA PET/CT findings was 48%, and EPE was not indicated by PET in any of the patients. The sensitivity, specificity, positive, and negative predictive value for SVI were 58%, 96%, 78%, 90%, respectively (area under the receiver operating characteristic curve = 0.77) and for LNI 67%, 98%, 67%, 98%, respectively (area under the receiver operating characteristic curve = 0.82). Incorporating imaging findings into the MSKCC-SVI nomogram enhanced the diagnostic accuracy from 0.84 to 0.95 (Integrated Discrimination Increment 0.24, P = 0.004). CONCLUSION: In patients with intermediate/high-risk prostate cancer, 68Ga-PSMA PET/CT provides information regarding intraprostatic tumor location, SVI and LNI but has no role in assessment for EPE. This information might be useful for pretreatment counseling, decision-making and possibly preoperative planning.
INTRODUCTION: Data on the accuracy of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with intermediate/high-risk prostate cancer are being accumulated. Its role in assessing the extent of local disease has not been fully elaborated. AIM: To determine the performance characteristics of 68Ga-PSMA PET/CT in identifying local disease extension in patients with intermediate/high risk prostate cancer. METHODS: 68Ga-PSMA PET/CT studies of 61 consecutive patients with intermediate/high-risk prostate cancer who underwent radical prostatectomy were reviewed by nuclear medicine specialists. Tumor location, extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph nodes involvement (LNI) were compared to pathological findings. The incremental value of 68Ga-PSMA PET/CT to established nomograms was determined. RESULTS: Two patients without pathologic uptake of 68Ga-PSMA were excluded. Seventeen patients were diagnosed with EPE (29%), 12(20%) had SVI and 3(5%) LNI. The concordance between tumor location and 68Ga-PSMA PET/CT findings was 48%, and EPE was not indicated by PET in any of the patients. The sensitivity, specificity, positive, and negative predictive value for SVI were 58%, 96%, 78%, 90%, respectively (area under the receiver operating characteristic curve = 0.77) and for LNI 67%, 98%, 67%, 98%, respectively (area under the receiver operating characteristic curve = 0.82). Incorporating imaging findings into the MSKCC-SVI nomogram enhanced the diagnostic accuracy from 0.84 to 0.95 (Integrated Discrimination Increment 0.24, P = 0.004). CONCLUSION: In patients with intermediate/high-risk prostate cancer, 68Ga-PSMA PET/CT provides information regarding intraprostatic tumor location, SVI and LNI but has no role in assessment for EPE. This information might be useful for pretreatment counseling, decision-making and possibly preoperative planning.
Authors: Riccardo Laudicella; Stephan Skawran; Daniela A Ferraro; Urs J Mühlematter; Alexander Maurer; Hannes Grünig; Hendrik J Rüschoff; Niels Rupp; Olivio Donati; Daniel Eberli; Irene A Burger Journal: Insights Imaging Date: 2022-04-15
Authors: Sungmin Woo; Soleen Ghafoor; Anton S Becker; Sangwon Han; Andreas G Wibmer; Hedvig Hricak; Irene A Burger; Heiko Schöder; Hebert Alberto Vargas Journal: Eur J Hybrid Imaging Date: 2020-09-09
Authors: B H E Jansen; Y J L Bodar; G J C Zwezerijnen; D Meijer; J P van der Voorn; J A Nieuwenhuijzen; M Wondergem; T A Roeleveld; R Boellaard; O S Hoekstra; R J A van Moorselaar; D E Oprea-Lager; A N Vis Journal: Eur J Nucl Med Mol Imaging Date: 2020-08-12 Impact factor: 9.236