Diagnostic ability of Ga-68 PSMA PET to detect dominant and non-dominant tumors, upgrading and adverse pathology in patients with PIRADS 4-5 index lesions undergoing radical prostatectomy

被引：20

作者：

Koseoglu, Ersin ^{[1
]}

Kordan, Yakup ^{[2
]}

Kilic, Mert ^{[3
]}

Sal, Oguzhan ^{[4
]}

Seymen, Hulya ^{[5
]}

Kiremit, Murat Can ^{[2
]}

Armutlu, Ayse ^{[6
]}

Baydar, Dilek Ertoy ^{[6
]}

Altinmakas, Emre ^{[7
]}

Vural, Metin ^{[8
]}

Falay, Okan ^{[5
]}

Canda, Abdullah Erdem ^{[2
]}

Balbay, Derya ^{[2
,3
]}

Demirkol, Mehmet Onur ^{[5
,9
]}

Esen, Tarik ^{[2
,3
]}

机构：

[1] Koc Univ Hosp, Dept Urol, Istanbul, Turkey

[2] Koc Univ, Sch Med, Dept Urol, Istanbul, Turkey

[3] VKF Amer Hosp, Dept Urol, Istanbul, Turkey

[4] Koc Univ, Sch Med, Istanbul, Turkey

[5] Koc Univ, Sch Med, Dept Nucl Med & Mol Imaging, Istanbul, Turkey

[6] Koc Univ, Sch Med, Dept Pathol, Istanbul, Turkey

[7] Koc Univ, Sch Med, Dept Radiol, Istanbul, Turkey

[8] VKF Amer Hosp, Dept Radiol, Istanbul, Turkey

[9] VKF Amer Hosp, Dept Nucl Med & Mol Med, Istanbul, Turkey

来源：

PROSTATE CANCER AND PROSTATIC DISEASES | 2021年 / 24卷 / 01期

关键词：

GA-68-PSMA-11; PET/CT; CANCER; ACCURACY; MRI; EXTENSION;

D O I：

10.1038/s41391-020-00270-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background To evaluate the additive role of Ga-68 PSMA PET as a primary staging tool in patients bearing prostate cancer in single PIRADS 4 or 5 index lesions. Methods Eighty-one biopsy-naive patients with preoperative mpMRI and Ga-68 PSMA PET who underwent radical prostatectomy (RP) were evaluated retrospectively. Forty-nine patients had PIRADS 4 and 32 had PIRADS 5 index lesions. The localization, grade, and volumetric properties of dominant (DT) and non-dominant tumors (NDT) in RP were compared to the index lesions of mpMRI and Ga-68 PSMA PET. Results The median age and PSA level were 62 (IQR; 59-69) years and 7 (IQR; 2-8) ng/ml, respectively. Ga-68 PSMA PET detected DTs in 100% of the patients including 13 patients in whom mpMR failed. In 45 patients an NDT was reported in RP. Ga-68 PSMA PET accurately detected NDT in 24 of 45 (53.3%) patients. Six patients (12.2%) in PIRADS 4 and 8 (25%) in PIRADS 5 group showed upgrading. In PIRADS 4, Ga-68 PSMA PET localized DT in all patients with upgraded tumors whereas mpMRI missed exact location in 2 of 6 (33.3%). In PIRADS 5 both mpMRI and Ga-68 PSMA PET accurately located all DTs. Overall detection rates of extracapsular extension (ECE) and seminal vesicle invasion (SVI) by mpMRI were 51.1% and 53.8%, respectively. Ga-68 PSMA PET detected ECE and SVI in 27.9% and 30.7%, respectively. When mpMRI and Ga-68 PSMA PET were used in combination detection rates of ECE and SVI increased to 65.1 and 61.5%. Ga-68 PSMA PET-detected six of ten patients with positive lymph nodes whereas mpMRI could not identify any. Conclusions Ga-68 PSMA PET has a better diagnostic accuracy in detecting DT, NDT, upgrading, adverse pathology in patients with PIRADS 4 index lesions. However, mpMRI better predicted ECE and SVI than Ga-68 PSMA PET.

引用

页码：202 / 209

页数：8

共 31 条

[1] PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions [J].