The role of PSMA PET/CT in identifying benign and malignant intracranial lesions in patients with prostate cancer.

IF 1.5 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Caitlin Deffler, Ashkan Eighaei Sedeh, Ellen Leitman, Thomas S C Ng, David Z Chow, Umar Mahmood, Pedram Heidari, Nathaniel Mercaldo, Shadi A Esfahani
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引用次数: 0

Abstract

Purpose: To evaluate the ability of prostate-specific membrane antigen (PSMA) PET/CT to detect and characterize intracranial lesions in patients with prostate cancer (PCa), using brain MRI as a gold standard method.

Methods: In this retrospective single-center study, standard-of-care 18F-piflufolastat and 68Ga-gozetotide PSMA PET/CT scans for PCa patients were reviewed from August 2021 to February 2023. Patients with a brain MRI taken within 6 months of their PSMA PET/CT were enrolled. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PSMA PET/CT were calculated for the detection of brain metastases. Lesion uptake and patients' clinical information, including prostate-specific antigen (PSA) were compared between metastatic and non-metastatic brain lesions.

Results: Of 1482 reviewed PCa patients, 141 with available brain MRI within six months of PSMA PET/CT were included. The estimated incidence rate of brain metastasis was 1.1 % (17/1482; Exact 95 % CI: 0.7-1.83), using brain MRI. PSMA PET/CT had a sensitivity of 81.2 % (95 % CI: 54.4-96.0), a specificity of 93.6 % (95 % CI: 87.8-97.2), a PPV of 61.9 % (95 % CI: 44.4-76.8), and an NPV of 97.5 % (95 % CI: 93.3-99.1) for detecting at least one metastatic PCa lesion as confirmed by MRI. Although not statistically significant, the mean SUVmax was higher in patients with intracranial PCa metastasis than those with other etiologies (fold change: 2.88, 95 % CI: 0.88, 9.43, p = 0.077), and a similar pattern was shown for mean PSA (fold-change: 17.2, 95 % CI: 0.95-312.6, p = 0.054).

Conclusion: Intracranial uptake on PSMA PET/CT may require further clinical and imaging correlation for accurate characterization.

PSMA PET/CT在鉴别前列腺癌患者颅内良恶性病变中的作用
目的:评价前列腺特异性膜抗原(PSMA) PET/CT检测和表征前列腺癌(PCa)患者颅内病变的能力,以脑MRI为金标准方法。方法:在这项回顾性单中心研究中,回顾了从2021年8月到2023年2月PCa患者的标准护理18f -哌氟他司他和68Ga-gozetotide PSMA PET/CT扫描。患者在PSMA PET/CT检查后6个月内进行了脑MRI检查。计算PSMA PET/CT检测脑转移的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)。比较转移性和非转移性脑病变的病变摄取和患者的临床信息,包括前列腺特异性抗原(PSA)。结果:1482例PCa患者中,141例在PSMA PET/CT检查后6个月内有可用的脑MRI。脑MRI估计脑转移发生率为1.1%(17/1482;确切95% CI: 0.7-1.83)。PSMA PET/CT对MRI证实的至少一种转移性PCa病变的敏感性为81.2% (95% CI: 54.4-96.0),特异性为93.6% (95% CI: 87.8-97.2), PPV为61.9% (95% CI: 44.4-76.8), NPV为97.5% (95% CI: 93.3-99.1)。虽然没有统计学意义,但颅内前列腺癌转移患者的平均SUVmax高于其他病因的患者(翻倍变化:2.88,95% CI: 0.88, 9.43, p = 0.077),平均PSA也显示类似的模式(翻倍变化:17.2,95% CI: 0.95-312.6, p = 0.054)。结论:PSMA PET/CT的颅内摄取可能需要进一步的临床和影像学相关性才能准确表征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Imaging
Clinical Imaging 医学-核医学
CiteScore
4.60
自引率
0.00%
发文量
265
审稿时长
35 days
期刊介绍: The mission of Clinical Imaging is to publish, in a timely manner, the very best radiology research from the United States and around the world with special attention to the impact of medical imaging on patient care. The journal''s publications cover all imaging modalities, radiology issues related to patients, policy and practice improvements, and clinically-oriented imaging physics and informatics. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Papers are carefully peer-reviewed and selected by our experienced subject editors who are leading experts spanning the range of imaging sub-specialties, which include: -Body Imaging- Breast Imaging- Cardiothoracic Imaging- Imaging Physics and Informatics- Molecular Imaging and Nuclear Medicine- Musculoskeletal and Emergency Imaging- Neuroradiology- Practice, Policy & Education- Pediatric Imaging- Vascular and Interventional Radiology
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