Peter Donato1,2, Andrew Morton3, John Yaxley4,3, Sachinka Ranasinghe4,3, Patrick E Teloken4,3, Samuel Kyle3,5, Geoff Coughlin4, Rachel Esler4, Nigel Dunglison4, Robert A Gardiner4,3,6,7, Matthew J Roberts8,9,10,11. 1. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia. peterdonato1@gmail.com. 2. Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia. peterdonato1@gmail.com. 3. Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia. 4. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia. 5. Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Herston, Australia. 6. Griffith University, Brisbane, Queensland, Australia. 7. Edith Cowan University, Joondalup, Australia. 8. Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia. m.roberts2@uq.edu.au. 9. Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia. m.roberts2@uq.edu.au. 10. Nepean Urology Research Group, Kingswood, Penrith, New South Wales, Australia. m.roberts2@uq.edu.au. 11. Discipline of Surgery, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia. m.roberts2@uq.edu.au.
Abstract
BACKGROUND: 68Ga prostate specific membrane antigen PET/CT (68Ga-PSMA PET/CT) may be superior to multiparametric MRI (mpMRI) for localisation of prostate cancer tumour foci, however the concordance and differences between 68Ga-PSMA PET/CT and mpMRI when applied to all biopsied patients and potential benefit in patients with negative mpMRI is unclear. METHODS: Retrospective analysis of patients undergoing mpMRI, prostate biopsy and 68Ga-PSMA PET/CT over a 3-year period. Diagnostic performance of 68Ga-PSMA PET/CT and mpMRI were assessed using biopsy histopathology for the entire cohort and radical prostatectomy specimen in a subset of patients. Lesion concordance and additional detection of each modality were determined, including in a dedicated cohort of patients with mpMRI PIRADS 2 scans. RESULTS: A total of 144 patients were included in the study. Index lesion/foci detection was similar between 68Ga-PSMA PET/CT and mpMRI (sensitivity 83.1% vs 90.1%; p = 0.267), however lesions missed by mpMRI were larger (1.66 cm3 vs 0.72 cm3; p = 0.034). Lesion detection rates were similar across the biopsy histopathology and radical prostatectomy specimen subset, with a high concordance for index (80.1%) and a moderate concordance for total (67%) lesions between the 2 imaging modalities. The additional detection yield favoured 68Ga-PSMA PET/CT over mpMRI for index (13.5% vs 4.3%) and total (18.2% vs 5.4%) lesions; both modalities missed 2.1% and 12.3% of index and total lesions, respectively. 68Ga-PSMA PET/CT identified 9 of 11 patients with PIRADS 2 mpMRI but subsequently diagnosed with Gleason ≥ 3 + 4 disease. CONCLUSIONS: Despite high concordance rates, 68Ga-PSMA PET/CT incrementally improved tumour localisation compared with mpMRI. These results suggest that 68Ga-PSMA PET/CT may have an incremental value to that of mpMRI in the diagnostic process for prostate.
BACKGROUND: 68Ga prostate specific membrane antigen PET/CT (68Ga-PSMA PET/CT) may be superior to multiparametric MRI (mpMRI) for localisation of prostate cancer tumour foci, however the concordance and differences between 68Ga-PSMA PET/CT and mpMRI when applied to all biopsied patients and potential benefit in patients with negative mpMRI is unclear. METHODS: Retrospective analysis of patients undergoing mpMRI, prostate biopsy and 68Ga-PSMA PET/CT over a 3-year period. Diagnostic performance of 68Ga-PSMA PET/CT and mpMRI were assessed using biopsy histopathology for the entire cohort and radical prostatectomy specimen in a subset of patients. Lesion concordance and additional detection of each modality were determined, including in a dedicated cohort of patients with mpMRI PIRADS 2 scans. RESULTS: A total of 144 patients were included in the study. Index lesion/foci detection was similar between 68Ga-PSMA PET/CT and mpMRI (sensitivity 83.1% vs 90.1%; p = 0.267), however lesions missed by mpMRI were larger (1.66 cm3 vs 0.72 cm3; p = 0.034). Lesion detection rates were similar across the biopsy histopathology and radical prostatectomy specimen subset, with a high concordance for index (80.1%) and a moderate concordance for total (67%) lesions between the 2 imaging modalities. The additional detection yield favoured 68Ga-PSMA PET/CT over mpMRI for index (13.5% vs 4.3%) and total (18.2% vs 5.4%) lesions; both modalities missed 2.1% and 12.3% of index and total lesions, respectively. 68Ga-PSMA PET/CT identified 9 of 11 patients with PIRADS 2 mpMRI but subsequently diagnosed with Gleason ≥ 3 + 4 disease. CONCLUSIONS: Despite high concordance rates, 68Ga-PSMA PET/CT incrementally improved tumour localisation compared with mpMRI. These results suggest that 68Ga-PSMA PET/CT may have an incremental value to that of mpMRI in the diagnostic process for prostate.
Entities:
Keywords:
Glutamate carboxypeptidase II; Human; Magnetic resonance imaging; Positron-emission tomography; Prostate specific membrane antigen; Prostatectomy; Prostatic neoplasms
Authors: Matthew J Roberts; Alastair Macdonald; Sachinka Ranasinghe; Harrison Bennett; Patrick E Teloken; Patrick Harris; David Paterson; Geoff Coughlin; Nigel Dunglison; Rachel Esler; Robert A Gardiner; Thomas Elliott; Louisa Gordon; John Yaxley Journal: Prostate Cancer Prostatic Dis Date: 2020-08-05 Impact factor: 5.554
Authors: Constantinos Zamboglou; Maria Kramer; Selina Kiefer; Peter Bronsert; Lara Ceci; August Sigle; Wolfgang Schultze-Seemann; Cordula A Jilg; Tanja Sprave; Thomas F Fassbender; Nils H Nicolay; Juri Ruf; Matthias Benndorf; Anca L Grosu; Simon K B Spohn Journal: Sci Rep Date: 2021-03-12 Impact factor: 4.379
Authors: Simon K B Spohn; Alisa S Bettermann; Fabian Bamberg; Matthias Benndorf; Michael Mix; Nils H Nicolay; Tobias Fechter; Tobias Hölscher; Radu Grosu; Arturo Chiti; Anca L Grosu; Constantinos Zamboglou Journal: Theranostics Date: 2021-07-06 Impact factor: 11.556