68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer

被引：52

作者：

von Klot C.-A.J. ^{[1
]}

Merseburger A.S. ^{[2
]}

Böker A. ^{[1
]}

Schmuck S. ^{[3
]}

Ross T.L. ^{[3
]}

Bengel F.M. ^{[3
]}

Kuczyk M.A. ^{[1
]}

Henkenberens C. ^{[4
]}

Christiansen H. ^{[4
]}

Wester H.-J. ^{[5
]}

Solass W. ^{[6
]}

Lafos M. ^{[6
]}

Derlin T. ^{[3
]}

机构：

[1] Department of Urology and Urological Oncology, Hannover Medical School, Hannover

[2] Department of Urology, Campus Lübeck University Hospital Schleswig-Holstein, Lübeck

[3] Department of Nuclear Medicine, Hannover Medical School, Hannover

[4] Department of Radiation Oncology, Hannover Medical School, Hannover

[5] Radiopharmaceutical Chemistry, Technical University Munich, Garching

[6] Institute for Pathology, Hannover Medical School, Hannover

来源：

Nuclear Medicine and Molecular Imaging | 2017年 / 51卷 / 4期

关键词：

Extracapsular extension; PET/CT; Prostate cancer; Prostate-specific membrane antigen (PSMA); Seminal vesicle; Staging;

D O I：

10.1007/s13139-017-0476-7

中图分类号：

学科分类号：

摘要：

Purpose: 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I&T (imaging and therapy) PET/CT prior to radical prostatectomy. Methods: The study population consisted of 21 patients with prostate cancer who underwent 68Ga-PSMA I&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology. Results: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUVmean of the primary tumors was 9.5 ± 8.8. SUVmean was higher in tumors with ECE than in organ-confined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (rs = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7%, 75.0%, 97.3% and 60.0% for tumor infiltration of an individual prostate lobe, 75.0%, 100.0%, 100.0% and 97.4% for SVI, and 90.0%, 90.9%, 90.0% and 90.9% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from 68Ga-PSMA I&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (rp = 0.75, p < 0.001) and tumor volume on histopathology (rp = 0.45, p = 0.039). Conclusions: 68Ga-PSMA I&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, 68Ga-PSMA I&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI. © 2017, Korean Society of Nuclear Medicine.

引用

页码：314 / 322

页数：8

共 34 条

[1]

Siegel R., Ma J., Zou Z., Jemal A., Cancer statistics. 2014, CA Cancer J Clin, 64, pp. 9-29, (2014)

[2]

Loeb S., Smith N.D., Roehl K.A., Catalona W.J., Intermediate-term potency, continence, and survival outcomes of radical prostatectomy for clinically high-risk or locally advanced prostate cancer, Urology, 69, pp. 1170-1175, (2007)

[3]

de Rooij M., Hamoen E.H., Witjes J.A., Barentsz J.O., Rovers M.M., Accuracy of magnetic resonance imaging for local staging of prostate cancer: a diagnostic meta-analysis, Eur Urol, 70, pp. 233-245, (2016)

[4]

Ball M.W., Partin A.W., Epstein J.I., Extent of extraprostatic extension independently influences biochemical recurrence-free survival: evidence for further pT3 subclassification, Urology, 85, pp. 161-164, (2015)

[5]

Ohori M., Scardino P.T., Lapin S.L., Seale-Hawkins C., Link J., Wheeler T.M., The mechanisms and prognostic significance of seminal vesicle involvement by prostate cancer, Am J Surg Pathol, 17, pp. 1252-1261, (1993)

[6]

Mullerad M., Hricak H., Kuroiwa K., Pucar D., Chen H.-N., Kattan M.W., Et al., Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancer, J Urol, 174, pp. 2158-2163, (2005)

[7]

Ward J.F., Slezak J.M., Blute M.L., Bergstralh E.J., Zincke H., Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome, BJU Int, 95, pp. 751-756, (2005)

[8]

Wright G., Haley C., Beckett M.L., Schellhammer P.F., Expression of prostate-specific membrane antigen in normal, benign, and malignant prostate tissues, Urol Oncol, 1, pp. 18-28, (1995)

[9]

Minner S., Wittmer C., Graefen M., Salomon G., Steuber T., Haese A., Et al., High level PSMA expression is associated with early PSA recurrence in surgically treated prostate cancer, Prostate, 71, pp. 281-288, (2011)

[10]

Herrmann K., Bluemel C., Weineisen M., Schottelius M., Wester H.-J., Czernin J., Et al., Biodistribution and radiation dosimetry for a probe targeting prostate-specific membrane antigen for imaging and therapy, J Nucl Med, 56, pp. 855-861, (2015)

← 1 2 3 4 →