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Title:

Simultaneous (68)Ga-PSMA HBED-CC PET/MRI Improves the Localization of Primary Prostate Cancer.

Document type:
Journal Article; Article
Author(s):
Eiber, Matthias; Weirich, Gregor; Holzapfel, Konstantin; Souvatzoglou, Michael; Haller, Bernhard; Rauscher, Isabel; Beer, Ambros J; Wester, Hans-Jürgen; Gschwend, Juergen; Schwaiger, Markus; Maurer, Tobias
Abstract:
Ligands of the prostate-specific membrane antigen (PSMA) show promising results in positron emission tomography (PET) imaging of prostate cancer (PCa).To compare the diagnostic performance of simultaneous gallium 68 ((68)Ga)-PSMA HBED-CC PET/magnetic resonance imaging (MRI) for localization of primary PCa with multiparametric magnetic resonance imaging (mpMRI) and PET alone.We performed (68)Ga-PSMA HBED-CC PET/MRI in 66 men with biopsy-proven PCa.PET, mpMRI, and combined (68)Ga-PSMA HBED-CC PET/MRI were independently evaluated using Prostate Imaging Reporting and Data System criteria or a 5-point Likert scale.The prostate was divided into sextants for histopathology and coregistered with imaging. Diagnostic performance for localization of malignancy was calculated based on receiver operating characteristics analysis for each modality. Regional quantitative PET tracer uptake was recorded; uptake ratio was defined as the ratio of malignant to nonmalignant prostate tissue.A total of 53 of 66 patients were eligible for analysis. mpMRI, PET, and PET/MRI detected cancer in 66% (35 of 53), 92% (49 of 53), and 98% (52 of 53) of the patients, respectively. Overall, 202 of 318 sextants (63.5%) contained cancer at pathologic examination. Simultaneous PET/MRI statistically outperformed mpMRI (area under the curve [AUC]: 0.88 vs 0.73; p<0.001) and PET imaging (AUC: 0.88 vs 0.83; p=0.002) for localization of PCa. Compared with mpMRI, PET imaging was more accurate (AUC: 0.83 vs 0.73; p=0.003). PET provided a high uptake ratio between malignant versus nonmalignant tissue (5.02 [range: 0.89-29.8]), but no significant correlation was observed between quantitative PET parameters and Gleason score or prostate-specific antigen value.Simultaneous (68)Ga-PSMA HBED-CC PET/MRI improves diagnostic accuracy for PCa localization both compared with mpMRI and with PET imaging alone. Further prospective studies are warranted to evaluate its potential (eg, for biopsy guidance).We examined gallium 68 ((68)Ga)-prostate-specific membrane antigen (PSMA) HBED-CC positron emission tomography/magnetic resonance imaging (PET/MRI) for primary prostate cancer (PCa) and compared it with multiparametric MRI and PET alone. Our results indicate a higher diagnostic accuracy for (68)Ga-PSMA HBED-CC PET/MRI that may help localize PCa.
Journal title abbreviation:
Eur Urol
Year:
2016
Journal volume:
70
Journal issue:
5
Pages contribution:
829-836
Language:
eng
Fulltext / DOI:
doi:10.1016/j.eururo.2015.12.053
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/26795686
Print-ISSN:
0302-2838
TUM Institution:
Institut für Allgemeine Pathologie und Pathologische Anatomie; Institut für Medizinische Statistik und Epidemiologie; Klinik und Poliklinik für Nuklearmedizin; Urologische Klinik und Poliklinik
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