68Ga-PSMA-PET/CT对癌症的检测和局部分期及其与mpMRI和组织病理学的比较

分子影像学(英文) Pub Date : 2020-07-30 DOI:10.4236/ami.2020.103003

F. Intema, A. Kooistra, M. Vermeulen, R. Hoeben, A. Berk, A. Lont, W. Dingemans, L. Andrews, G. Lammers, J. D. Klerk

{"title":"68Ga-PSMA-PET/CT对癌症的检测和局部分期及其与mpMRI和组织病理学的比较","authors":"F. Intema, A. Kooistra, M. Vermeulen, R. Hoeben, A. Berk, A. Lont, W. Dingemans, L. Andrews, G. Lammers, J. D. Klerk","doi":"10.4236/ami.2020.103003","DOIUrl":null,"url":null,"abstract":"Introduction: 68Ga-PSMA-PET/CT has proven its value in prostate cancer with high positive predictive value for lymph node metastasis and superior detection of distant metastasis. There is growing evidence that 68Ga-PSMA- PET/CT has high sensitivity for detection of tumor lesions in the prostate as well. Studies thus far have mainly been performed in patients prior to prostatectomy. Aim of this study is to evaluate diagnostic accuracy in a mixed population of men with increased risk of prostate cancer and evaluate diagnostic possibilities with respect to extra-capsular extension and seminal vesicle invasion. Methods: The population consisted of a retrospectively included sequential cohort of 69 patients with 68Ga-PSMA-PET/CT and mpMRI available. 68Ga-PSMA-PET/CT was re-evaluated by two readers blinded for mpMRI and clinical information. Likelihood of tumour presence, extra-prostatic extension and seminal vesicle invasion was scored on 5-point Likert scale and localized schematically. Results were compared with mpMRI. Available pathological outcome served as gold standard. SUVmax of index lesions was measured and correlated to index tumor Gleason grade. Results: Clinically significant prostate cancer (Gleason ≥ 3 + 4) was detected in 57 (83%) of 69 patients. Diagnostic accuracy was 89% for PET reader 1, 93% for PET reader 2 and 86% for mpMRI. Lesion concordance of 68Ga-PSMA-PET/CT and mpMRI was 97%. SUVmax of the index lesion correlated to Gleason grade. Sensitivity for extracapsular extension in the prostatectomy group was 62% for PET reader 1, 33% for PET reader 2 and 50% for mpMRI. Specificity was 62% for PET reader 1, 100% for PET reader 2 and 69% for mpMRI. Conclusion: Ga68-PSMA-PET shows high accuracy in the detection of tumor lesions in the prostate. Results on evaluating extra-capsular extension and seminal vesicle invasion are comparable to mpMRI. This study adds to the increasing evidence that 68Ga-PSMA-PET/CT is imperative in detection of prostate cancer prior to biopsy.","PeriodicalId":64843,"journal":{"name":"分子影像学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Detection and Local Staging of Prostate Cancer by 68Ga-PSMA-PET/CT, Comparison with mpMRI and Histopathology\",\"authors\":\"F. Intema, A. Kooistra, M. Vermeulen, R. Hoeben, A. Berk, A. Lont, W. Dingemans, L. Andrews, G. Lammers, J. D. Klerk\",\"doi\":\"10.4236/ami.2020.103003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: 68Ga-PSMA-PET/CT has proven its value in prostate cancer with high positive predictive value for lymph node metastasis and superior detection of distant metastasis. There is growing evidence that 68Ga-PSMA- PET/CT has high sensitivity for detection of tumor lesions in the prostate as well. Studies thus far have mainly been performed in patients prior to prostatectomy. Aim of this study is to evaluate diagnostic accuracy in a mixed population of men with increased risk of prostate cancer and evaluate diagnostic possibilities with respect to extra-capsular extension and seminal vesicle invasion. Methods: The population consisted of a retrospectively included sequential cohort of 69 patients with 68Ga-PSMA-PET/CT and mpMRI available. 68Ga-PSMA-PET/CT was re-evaluated by two readers blinded for mpMRI and clinical information. Likelihood of tumour presence, extra-prostatic extension and seminal vesicle invasion was scored on 5-point Likert scale and localized schematically. Results were compared with mpMRI. Available pathological outcome served as gold standard. SUVmax of index lesions was measured and correlated to index tumor Gleason grade. Results: Clinically significant prostate cancer (Gleason ≥ 3 + 4) was detected in 57 (83%) of 69 patients. Diagnostic accuracy was 89% for PET reader 1, 93% for PET reader 2 and 86% for mpMRI. Lesion concordance of 68Ga-PSMA-PET/CT and mpMRI was 97%. SUVmax of the index lesion correlated to Gleason grade. Sensitivity for extracapsular extension in the prostatectomy group was 62% for PET reader 1, 33% for PET reader 2 and 50% for mpMRI. Specificity was 62% for PET reader 1, 100% for PET reader 2 and 69% for mpMRI. Conclusion: Ga68-PSMA-PET shows high accuracy in the detection of tumor lesions in the prostate. Results on evaluating extra-capsular extension and seminal vesicle invasion are comparable to mpMRI. This study adds to the increasing evidence that 68Ga-PSMA-PET/CT is imperative in detection of prostate cancer prior to biopsy.\",\"PeriodicalId\":64843,\"journal\":{\"name\":\"分子影像学(英文)\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"分子影像学(英文)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4236/ami.2020.103003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"分子影像学(英文)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4236/ami.2020.103003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

简介：68Ga-PSMA-PET/CT已证明其在前列腺癌症中的价值，对淋巴结转移的阳性预测价值高，对远处转移的检测效果好。越来越多的证据表明68Ga PSMA-PET/CT对前列腺肿瘤病变的检测也具有高灵敏度。到目前为止，研究主要是在前列腺切除术前对患者进行的。本研究的目的是评估癌症风险增加的男性混合人群的诊断准确性，并评估囊外扩张和精囊侵袭的诊断可能性。方法：人群由69名患者组成，他们采用68Ga-PSMA PET/CT和mpMRI。68Ga PSMA PET/CT由两名对mpMRI和临床信息不知情的读者重新评估。肿瘤存在、前列腺外扩张和精囊浸润的可能性在Likert 5分量表上进行评分，并进行示意性定位。将结果与mpMRI进行比较。可用的病理结果作为金标准。测量指标性病变的SUVmax，并与指标性肿瘤Gleason分级相关。结果：69例前列腺癌患者中有57例（83%）检出有临床意义的前列腺癌（Gleason≥3+4）。PET阅读器1的诊断准确率为89%，PET阅读器2为93%，mpMRI为86%。68Ga-PSMA PET/CT和mpMRI的病变符合率为97%。指数病变的SUVmax与Gleason分级相关。前列腺切除术组的PET阅读器1对囊外延伸的敏感性为62%，PET阅读器2为33%，mpMRI为50%。PET阅读器1的特异性为62%，PET阅读器2为100%，mpMRI为69%。结论：Ga68PSMAPET对前列腺肿瘤的检测具有较高的准确性。囊外扩张和精囊浸润的评估结果与mpMRI相当。这项研究增加了越来越多的证据，证明68Ga-PSMA-PET/CT在活检前检测前列腺癌症是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Detection and Local Staging of Prostate Cancer by 68Ga-PSMA-PET/CT, Comparison with mpMRI and Histopathology

Introduction: 68Ga-PSMA-PET/CT has proven its value in prostate cancer with high positive predictive value for lymph node metastasis and superior detection of distant metastasis. There is growing evidence that 68Ga-PSMA- PET/CT has high sensitivity for detection of tumor lesions in the prostate as well. Studies thus far have mainly been performed in patients prior to prostatectomy. Aim of this study is to evaluate diagnostic accuracy in a mixed population of men with increased risk of prostate cancer and evaluate diagnostic possibilities with respect to extra-capsular extension and seminal vesicle invasion. Methods: The population consisted of a retrospectively included sequential cohort of 69 patients with 68Ga-PSMA-PET/CT and mpMRI available. 68Ga-PSMA-PET/CT was re-evaluated by two readers blinded for mpMRI and clinical information. Likelihood of tumour presence, extra-prostatic extension and seminal vesicle invasion was scored on 5-point Likert scale and localized schematically. Results were compared with mpMRI. Available pathological outcome served as gold standard. SUVmax of index lesions was measured and correlated to index tumor Gleason grade. Results: Clinically significant prostate cancer (Gleason ≥ 3 + 4) was detected in 57 (83%) of 69 patients. Diagnostic accuracy was 89% for PET reader 1, 93% for PET reader 2 and 86% for mpMRI. Lesion concordance of 68Ga-PSMA-PET/CT and mpMRI was 97%. SUVmax of the index lesion correlated to Gleason grade. Sensitivity for extracapsular extension in the prostatectomy group was 62% for PET reader 1, 33% for PET reader 2 and 50% for mpMRI. Specificity was 62% for PET reader 1, 100% for PET reader 2 and 69% for mpMRI. Conclusion: Ga68-PSMA-PET shows high accuracy in the detection of tumor lesions in the prostate. Results on evaluating extra-capsular extension and seminal vesicle invasion are comparable to mpMRI. This study adds to the increasing evidence that 68Ga-PSMA-PET/CT is imperative in detection of prostate cancer prior to biopsy.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

分子影像学(英文)

自引率

0.00%

发文量