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Prospective comparison of whole-body MRI and 68Ga-PSMA PET/CT for the detection of biochemical recurrence of prostate cancer after radical prostatectomy.
Sawicki, Lino M; Kirchner, Julian; Buddensieck, Carolin; Antke, Christina; Ullrich, Tim; Schimmöller, Lars; Boos, Johannes; Schleich, Christoph; Schaarschmidt, Benedikt M; Buchbender, Christian; Heusch, Philipp; Rabenalt, Robert; Albers, Peter; Antoch, Gerald; Müller, Hans-Wilhelm; Hautzel, Hubertus.
Afiliação
  • Sawicki LM; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Kirchner J; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Buddensieck C; Department of Urology, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
  • Antke C; Department of Nuclear Medicine, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
  • Ullrich T; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Schimmöller L; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Boos J; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany. johannes.boos@med.uni-duesseldorf.de.
  • Schleich C; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Schaarschmidt BM; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Buchbender C; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Heusch P; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Rabenalt R; Department of Urology, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
  • Albers P; Department of Urology, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
  • Antoch G; Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225, Dusseldorf, Germany.
  • Müller HW; Department of Nuclear Medicine, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
  • Hautzel H; Department of Nuclear Medicine, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
Eur J Nucl Med Mol Imaging ; 46(7): 1542-1550, 2019 Jul.
Article em En | MEDLINE | ID: mdl-30879122
PURPOSE: To assess whole-body magnetic resonance imaging (wb-MRI) for detection of biochemical recurrence in comparison to 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) in prostate cancer (Pca) patients after radical prostatectomy. METHODS: This was a prospective trial including 28 consecutive patients (mean age 65.3 ± 9.0 years) with newly documented biochemical recurrence of Pca (mean prostate-specific antigen, PSA, 2.09 ± 1.95 ng/ml) following radical prostatectomy. All patients underwent both wb-MRI including a dedicated pelvic imaging protocol and PET/CT with 166 ± 35 MBq 68Ga-PSMA within a time window of 11 ± 10 days. PET/CT and MRI datasets were separately evaluated regarding Pca lesion count, type, localization and diagnostic confidence (three-point Likert scale, 1-3) by two nuclear medicine specialists and two radiologists, respectively. The reference standard was based on histopathological results, PSA levels following targeted salvage irradiation and follow-up imaging. Lesion-based and patient-based detection rates were compared using the chi-squared test. Differences in diagnostic confidence were assessed using the Welch test. RESULTS: A total of 56 Pca lesions were detected in 20 of the 28 patients. 68Ga-PSMA PET/CT detected 56 of 56 lesions (100%) in 20 patients (71.4%), while wb-MRI detected 13 lesions (23.2%) in 11 patients (39.3%). The higher detection rate with 68Ga-PSMA PET/CT was statistically significant on both a per-lesion basis (p < 0.001) and a per-patient basis (p = 0.0167). In 8 patients (28.6%) no relapse was detectable by either modality. All lesions detected by wb-MRI were also detected by 68Ga-PSMA PET/CT. Additionally, 68Ga-PSMA PET/CT provided superior diagnostic confidence in identifying Pca lesions (2.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.044). CONCLUSION: 68Ga-PSMA PET/CT significantly out-performed wb-MRI in the detection of biochemical recurrence in Pca patients after radical prostatectomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Imageamento por Ressonância Magnética / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Eur J Nucl Med Mol Imaging Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Imageamento por Ressonância Magnética / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Eur J Nucl Med Mol Imaging Ano de publicação: 2019 Tipo de documento: Article