The Journal of Nuclear Medicine ( IF 9.3 ) Pub Date : 2017-11-01 , DOI: 10.2967/jnumed.116.189233 Claudia Kesch , Maria Vinsensia , Jan P. Radtke , Heinz P. Schlemmer , Martina Heller , Elena Ellert , Tim Holland-Letz , Stefan Duensing , Nils Grabe , Ali Afshar-Oromieh , Kathrin Wieczorek , Martin Schäfer , Oliver C. Neels , Jens Cardinale , Clemens Kratochwil , Markus Hohenfellner , Klaus Kopka , Uwe Haberkorn , Boris A. Hadaschik , Frederik L. Giesel
68Ga-prostate-specific membrane antigen (PSMA)-11 PET/CT represents an advanced method for the staging of primary prostate cancer (PCa) and diagnosis of recurrent or metastatic PCa. However, because of the narrow availability of 68Ga the development of alternative tracers is of high interest. The objective of this study was to examine the value of the new PET tracer 18F-PSMA-1007 for the staging of local disease by comparing it with multiparametric MRI (mpMRI) and radical prostatectomy (RP) histopathology. Methods: In 2016, 18F-PSMA-1007 PET/CT was performed in 10 men with biopsy-confirmed high-risk PCa. Nine patients underwent mpMRI in the process of primary diagnosis. Consecutively, RP was performed in all 10 men. Agreement analysis was performed retrospectively. PSMA staining was added for representative sections in RP specimen slices. Localization and agreement analysis of 18F-PSMA-1007 PET/CT, mpMRI, and RP specimens was performed by dividing the prostate into 38 sections as described in the prostate imaging reporting and data system (PI-RADS) (version 2). Sensitivity, specificity, positive predictive values, negative predictive values (NPVs), and accuracy were calculated for total and near-total agreement. Results: 18F-PSMA-1007 PET/CT had an NPV of 68% and an accuracy of 75%, and mpMRI had an NPV of 88% and an accuracy of 73% for total agreement. Near-total agreement analysis resulted in an NPV of 91% and an accuracy of 93% for 18F-PSMA-1007 PET/CT and 91% and 87% for mpMRI, respectively. Retrospective combination of mpMRI and PET/CT had an accuracy of 81% for total and 93% for near-total agreement. Conclusion: Comparison with RP histopathology demonstrates that 18F-PSMA-1007 PET/CT is promising for accurate local staging of PCa.
中文翻译:
原发性前列腺癌患者中18 F-PSMA-1007 PET / CT,多参数MRI和根治性前列腺切除术标本的个体内比较:一项回顾性概念验证研究
68 Ga-前列腺特异性膜抗原(PSMA)-11 PET / CT代表了一种用于分期原发性前列腺癌(PCa)和诊断复发或转移性PCa的先进方法。但是,由于68 Ga的适用范围很窄,因此开发替代示踪剂引起了人们的极大兴趣。这项研究的目的是通过与多参数MRI(mpMRI)和根治性前列腺切除术(RP)的组织病理学进行比较,检查新型PET示踪剂18 F-PSMA-1007在局部疾病分期中的价值。方法: 2016年,18F-PSMA-1007 PET / CT在10例经活检证实为高危PCa的男性中进行。9名患者在初步诊断过程中接受了mpMRI检查。连续在所有10名男性中进行了RP。协议分析是回顾性的。对于RP标本切片中的代表性切片,添加了PSMA染色。如前列腺成像报告和数据系统(PI-RADS)(版本2)中所述,通过将前列腺分为38个部分,对18个F-PSMA-1007 PET / CT,mpMRI和RP标本进行定位和一致性分析。计算总和几乎一致的敏感性,特异性,阳性预测值,阴性预测值(NPV)和准确性。结果: 18F-PSMA-1007 PET / CT的NPV为68%,准确度为75%,而mpMRI的NPV为88%,准确度为73%。几乎完全一致的分析结果显示18 F-PSMA-1007 PET / CT的NPV分别为91%和93 %,mpMRI的准确度分别为91%和87%。mpMRI和PET / CT的回顾性组合对整体的准确度为81%,对几乎整体的准确度为93%。结论:与RP组织病理学比较表明,18 F-PSMA-1007 PET / CT有希望用于PCa的准确局部分期。