Caitlin Deffler, Ashkan Eighaei Sedeh, Ellen Leitman, Thomas S C Ng, David Z Chow, Umar Mahmood, Pedram Heidari, Nathaniel Mercaldo, Shadi A Esfahani
{"title":"PSMA PET/CT在鉴别前列腺癌患者颅内良恶性病变中的作用","authors":"Caitlin Deffler, Ashkan Eighaei Sedeh, Ellen Leitman, Thomas S C Ng, David Z Chow, Umar Mahmood, Pedram Heidari, Nathaniel Mercaldo, Shadi A Esfahani","doi":"10.1016/j.clinimag.2025.110620","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>In this retrospective single-center study, standard-of-care <sup>18</sup>F-piflufolastat and <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>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 SUV<sub>max</sub> 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).</p><p><strong>Conclusion: </strong>Intracranial uptake on PSMA PET/CT may require further clinical and imaging correlation for accurate characterization.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":" ","pages":"110620"},"PeriodicalIF":1.5000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The role of PSMA PET/CT in identifying benign and malignant intracranial lesions in patients with prostate cancer.\",\"authors\":\"Caitlin Deffler, Ashkan Eighaei Sedeh, Ellen Leitman, Thomas S C Ng, David Z Chow, Umar Mahmood, Pedram Heidari, Nathaniel Mercaldo, Shadi A Esfahani\",\"doi\":\"10.1016/j.clinimag.2025.110620\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>In this retrospective single-center study, standard-of-care <sup>18</sup>F-piflufolastat and <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>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 SUV<sub>max</sub> 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).</p><p><strong>Conclusion: </strong>Intracranial uptake on PSMA PET/CT may require further clinical and imaging correlation for accurate characterization.</p>\",\"PeriodicalId\":50680,\"journal\":{\"name\":\"Clinical Imaging\",\"volume\":\" \",\"pages\":\"110620\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.clinimag.2025.110620\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.clinimag.2025.110620","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The role of PSMA PET/CT in identifying benign and malignant intracranial lesions in patients with prostate cancer.
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.
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