INTRODUCTION Prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET/CT) represents the upcoming standard for the staging of prostate cancer (PCa). However, there is still an unmet need for the validation of PSMA PET/CT at primary staging and consecutive histological correlation. Consequently, we decided to analyze the prediction parameter of PSMA PET/CT at primary staging. METHODS We relied on 90 ≥ intermediate-risk PCa patients treated with radical prostatectomy (RP) and extended pelvic lymph node dissection. All patients were administered to 68Ga-PSMA PET/CT prior to surgery. 68Ga-PSMA PET/CT data were retrospectively reevaluated by a single radiologist and consequently compared to histological results from RP. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the detection of lymph node metastases were analyzed per-patient (n = 90), per-pelvic side (n = 180), and per-anatomic-region (external iliac artery and vein left/right vs. obturator fossa left/right vs. internal iliac artery left/right) (n = 458), respectively. RESULTS Sensitivity, specificity, PPV, and NPV per-patient were: 43.8, 96.0, 70.0, and 88.8%, respectively. Sensitivity, specificity, PPV, and NPV per-pelvic-side were: 42.9, 95.6, 56.3, and 92.7%, respectively. Sensitivity, specificity, PPV, and NPV per-anatomic-region were: 47.6, 98.9, 66.7, and 97.5%, respectively. CONCLUSIONS Negative 68Ga-PSMA PET/CT results were highly reliable in our study. Positive 68Ga-PSMA PET/CT results, however, revealed less reliable results. Larger and ideally prospective trials are justified to clarify the potential role of PSMA PET/CT based primary staging.

中文翻译：

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根治性前列腺切除术扩大盆腔淋巴结清扫后基于68Ga-PSMA PET / CT的主要分期和组织学相关性。

简介前列腺特异性膜抗原正电子发射断层扫描计算机断层扫描（PSMA PET / CT）代表了即将到来的前列腺癌（PCa）分期标准。然而，在初级阶段和连续的组织学相关性方面，仍然需要对PSMA PET / CT进行验证。因此，我们决定在初级阶段分析PSMA PET / CT的预测参数。方法我们依靠90例≥中等风险的PCa患者接受根治性前列腺切除术（RP）和扩大的盆腔淋巴结清扫术。所有患者在手术前均接受68Ga-PSMA PET / CT治疗。一位放射线医师对68Ga-PSMA PET / CT数据进行了回顾性重新评估，并与RP的组织学结果进行了比较。敏感性，特异性，阳性预测值（PPV），每个患者（n = 90），每个骨盆侧（n = 180）和每个解剖区域（外动脉和静脉的左/右）分析检测淋巴结转移的阴性预测值（NPV）分别与左/右闭孔窝和左/右内动脉相比（n = 458）。结果每位患者的敏感性，特异性，PPV和NPV分别为：43.8、96.0、70.0和88.8％。骨盆侧的敏感性，特异性，PPV和NPV分别为：42.9、95.6、56.3和92.7％。每个解剖区域的灵敏度，特异性，PPV和NPV分别为：47.6、98.9、66.7和97.5％。结论68Ga-PSMA PET / CT阴性结果在我们的研究中非常可靠。但是，68Ga-PSMA PET / CT阳性结果显示可靠性较差。