Markus Kroenke1, Alexander Wurzer2, Kristina Schwamborn3, Lena Ulbrich1, Lena Jooß1, Tobias Maurer4, Thomas Horn5, Isabel Rauscher1, Bernhard Haller6, Michael Herz1, Hans-Jürgen Wester2, Wolfgang A Weber1, Matthias Eiber7. 1. Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. 2. Technical University of Munich, Munich, Germany. 3. Institute of Pathology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. 4. Martini-Klinik and Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 5. Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and. 6. Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany. 7. Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany matthias.eiber@tum.de.
Abstract
18F-rhPSMA-7 (radiohybrid prostate-specific membrane antigen [PSMA]) is a novel ligand for PET imaging. Here, we present data from a retrospective analysis using PET/CT and PET/MRI examinations to investigate the efficacy of 18F-rhPSMA-7 PET for primary N-staging of patients with prostate cancer (PC) compared with morphologic imaging (CT or MRI) and validated by histopathology. Methods: Data from 58 patients with high-risk PC (according to the D'Amico criteria) who were staged with 18F-rhPSMA-7 PET/CT or PET/MRI at our institution between July 2017 and June 2018 were reviewed. The patients had a median prescan prostate-specific antigen value of 12.2 ng/mL (range, 1.2-81.6 ng/mL). The median injected activity of 18F-rhPSMA-7 was 327 MBq (range, 132-410 MBq), with a median uptake time of 79.5 min (range, 60-153 min). All patients underwent subsequent radical prostatectomy and extended pelvic lymph node dissection. The presence of lymph node metastases was determined by an experienced reader independently for both the PET and the morphologic datasets using a template-based analysis on a 5-point scale. Patient-level and template-based results were both compared with histopathologic findings. Results: Lymph node metastases were present in 18 patients (31.0%) and were located in 52 of 375 templates (13.9%). Receiver-operating-characteristic analyses showed 18F-rhPSMA-7 PET to perform significantly better than morphologic imaging on both patient-based and template-based analyses (areas under curve, 0.858 vs. 0.649 [P = 0.012] and 0.765 vs. 0.589 [P < 0.001], respectively). On patient-based analyses, the sensitivity, specificity, and accuracy of 18F-rhPSMA-7 PET were 72.2%, 92.5%, and 86.2%, respectively, and those of morphologic imaging were 50.0%, 72.5%, and 65.5%, respectively. On template-based analyses, the sensitivity, specificity, and accuracy of 18F-rhPSMA-7 PET were 53.8%, 96.9%, and 90.9%, respectively, and those of morphologic imaging were 9.6%, 95.0%, and 83.2%, respectively. Conclusion: 18F-rhPSMA-7 PET is superior to morphologic imaging for N-staging of high-risk primary PC. The efficacy of 18F-rhPSMA-7 is similar to published data for 68Ga-PSMA-11.
18F-rhPSMA-7 (radiohybrid prostate-specific membrane antigen [PSMA]) is a novel ligand for PET imaging. Here, we present data from a retrospective analysis using PET/CT and PET/MRI examinations to investigate the efficacy of 18F-rhPSMA-7 PET for primary N-staging of patients with prostate cancer (PC) compared with morphologic imaging (CT or MRI) and validated by histopathology. Methods: Data from 58 patients with high-risk PC (according to the D'Amico criteria) who were staged with 18F-rhPSMA-7 PET/CT or PET/MRI at our institution between July 2017 and June 2018 were reviewed. The patients had a median prescan prostate-specific antigen value of 12.2 ng/mL (range, 1.2-81.6 ng/mL). The median injected activity of 18F-rhPSMA-7 was 327 MBq (range, 132-410 MBq), with a median uptake time of 79.5 min (range, 60-153 min). All patients underwent subsequent radical prostatectomy and extended pelvic lymph node dissection. The presence of lymph node metastases was determined by an experienced reader independently for both the PET and the morphologic datasets using a template-based analysis on a 5-point scale. Patient-level and template-based results were both compared with histopathologic findings. Results: Lymph node metastases were present in 18 patients (31.0%) and were located in 52 of 375 templates (13.9%). Receiver-operating-characteristic analyses showed 18F-rhPSMA-7 PET to perform significantly better than morphologic imaging on both patient-based and template-based analyses (areas under curve, 0.858 vs. 0.649 [P = 0.012] and 0.765 vs. 0.589 [P < 0.001], respectively). On patient-based analyses, the sensitivity, specificity, and accuracy of 18F-rhPSMA-7 PET were 72.2%, 92.5%, and 86.2%, respectively, and those of morphologic imaging were 50.0%, 72.5%, and 65.5%, respectively. On template-based analyses, the sensitivity, specificity, and accuracy of 18F-rhPSMA-7 PET were 53.8%, 96.9%, and 90.9%, respectively, and those of morphologic imaging were 9.6%, 95.0%, and 83.2%, respectively. Conclusion: 18F-rhPSMA-7 PET is superior to morphologic imaging for N-staging of high-risk primary PC. The efficacy of 18F-rhPSMA-7 is similar to published data for 68Ga-PSMA-11.
Authors: Divya Yadav; Hyunsoo Hwang; Wei Qiao; Rituraj Upadhyay; Brian F Chapin; Chad Tang; Ana Aparicio; Maria A Lopez-Olivo; Stella K Kang; Homer A Macapinlac; Tharakeswara K Bathala; Devaki Shilpa Surasi Journal: Radiol Imaging Cancer Date: 2022-03
Authors: Benedikt Feuerecker; Maythinee Chantadisai; Anne Allmann; Robert Tauber; Jakob Allmann; Lisa Steinhelfer; Isabel Rauscher; Alexander Wurzer; Hans-Jürgen Wester; Wolfgang A Weber; Calogero d'Alessandria; Matthias Eiber Journal: J Nucl Med Date: 2021-09-16 Impact factor: 11.082
Authors: Simona Malaspina; Mikael Anttinen; Pekka Taimen; Ivan Jambor; Minna Sandell; Irina Rinta-Kiikka; Sami Kajander; Jukka Schildt; Ekaterina Saukko; Tommi Noponen; Jani Saunavaara; Peter B Dean; Roberto Blanco Sequeiros; Hannu J Aronen; Jukka Kemppainen; Marko Seppänen; Peter J Boström; Otto Ettala Journal: Eur J Nucl Med Mol Imaging Date: 2021-03-13 Impact factor: 9.236
Authors: Alexander Wurzer; Daniel Di Carlo; Michael Herz; Antonia Richter; Stephanie Robu; Ralf Schirrmacher; Alba Mascarin; Wolfgang Weber; Matthias Eiber; Markus Schwaiger; Hans-Juergen Wester Journal: EJNMMI Radiopharm Chem Date: 2021-01-23
Authors: Alexander Wurzer; Mara Parzinger; Matthias Konrad; Roswitha Beck; Thomas Günther; Veronika Felber; Stefanie Färber; Daniel Di Carlo; Hans-Jürgen Wester Journal: EJNMMI Res Date: 2020-12-07 Impact factor: 3.138
Authors: Alexander Wurzer; Daniel Di Carlo; Alexander Schmidt; Roswitha Beck; Matthias Eiber; Markus Schwaiger; Hans-Jürgen Wester Journal: J Nucl Med Date: 2019-12-20 Impact factor: 10.057
Authors: Tuula Tolvanen; Kari Kalliokoski; Simona Malaspina; Anna Kuisma; Salla Lahdenpohja; Ernst J Postema; Matthew P Miller; Mika Scheinin Journal: J Nucl Med Date: 2020-10-16 Impact factor: 10.057
Authors: Simona Malaspina; Vesa Oikonen; Anna Kuisma; Otto Ettala; Kalle Mattila; Peter J Boström; Heikki Minn; Kari Kalliokoski; Ernst J Postema; Matthew P Miller; Mika Scheinin Journal: Eur J Nucl Med Mol Imaging Date: 2021-04-12 Impact factor: 9.236