Intra-individual comparison of 68Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer |
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Authors: | F. L. Giesel F. Sterzing H. P. Schlemmer T. Holland-Letz W. Mier M. Rius A. Afshar-Oromieh K. Kopka J. Debus U. Haberkorn C. Kratochwil |
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Affiliation: | 1.Department of Nuclear Medicine,University Hospital Heidelberg,Heidelberg,Germany;2.Department of RadioOncology,University Hospital Heidelberg,Heidelberg,Germany;3.Department of Radiology,German Cancer Research Center (DKFZ),Heidelberg,Germany;4.Department of Biostatistics,German Cancer Research Center (DKFZ),Heidelberg,Germany;5.Institute of Transuranium Elements,European Commission (EC),Karlsruhe,Germany;6.Unit of Radiopharmaceutic Chemistry,German Cancer Research Center,Heidelberg,Germany;7.Division of Radiopharmaceutical Chemistry,German Cancer Research Center (DKFZ),Heidelberg,Germany |
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Abstract: | PurposeMulti-parametric magnetic resonance imaging (MP-MRI) is currently the most comprehensive work up for non-invasive primary tumor staging of prostate cancer (PCa). Prostate-specific membrane antigen (PSMA)-Positron emission tomography–computed tomography (PET/CT) is presented to be a highly promising new technique for N- and M-staging in recurrent PCa-patients. The actual investigation analyses the potential of 68Ga-PSMA11-PET/CT to assess the extent of primary prostate cancer by intra-individual comparison to MP-MRI.MethodsIn a retrospective study, ten patients with primary PCa underwent MP-MRI and PSMA-PET/CT for initial staging. All tumors were proven histopathological by biopsy. Image analysis was done in a quantitative (SUVmax) and qualitative (blinded read) fashion based on PI-RADS. The PI-RADS schema was then translated into a 3D-matrix and the euclidian distance of this coordinate system was used to quantify the extend of agreement.ResultsBoth MP-MRI and PSMA-PET/CT presented a good allocation of the PCa, which was also in concordance to the tumor location validated in eight-segment resolution by biopsy. An Isocontour of 50 % SUVmax in PSMA-PET resulted in visually concordant tumor extension in comparison to MP-MRI (T2w and DWI). For 89.4 % of sections containing a tumor according to MP-MRI, the tumor was also identified in total or near-total agreement (euclidian distance ≤1) by PSMA-PET. Vice versa for 96.8 % of the sections identified as tumor bearing by PSMA-PET the tumor was also found in total or near-total agreement by MP-MRI.ConclusionsPSMA-PET/CT and MP-MRI correlated well with regard to tumor allocation in patients with a high pre-test probability for large tumors. Further research will be needed to evaluate its value in challenging situation such as prostatitis or after repeated negative biopsies. |
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