Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study
Objectives Despite the advantages of prostate-specific membrane antigen (PSMA)-PET/MR over PSMA-PET/CT, its relatively long scanning time and suboptimal PET attenuation correction necessitate careful assessment of the most appropriate setting for this type of study. We assessed lesion agreement betw...
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| Veröffentlicht in: | European radiology 2020, Vol.30 (1), p.328-336 |
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| creator | Domachevsky, Liran Bernstine, Hanna Goldberg, Natalia Nidam, Meital Catalano, Onofrio A. Groshar, David |
| description | Objectives
Despite the advantages of prostate-specific membrane antigen (PSMA)-PET/MR over PSMA-PET/CT, its relatively long scanning time and suboptimal PET attenuation correction necessitate careful assessment of the most appropriate setting for this type of study. We assessed lesion agreement between PSMA-PET/MR and PSMA-PET/CT in patients undergoing initial evaluation of prostate cancer.
Methods
This was a prospective study of consecutive patients with histological biopsy-proven prostate cancer who underwent pelvic PSMA-PET/MR followed by whole-body PSMA-PET/CT. All conspicuous PSMA-avid foci were counted on PSMA-PET/CT and PSMA-PET/MR with CT or MR correlation. Analysis was performed for intra-prostatic lesions, capsular invasion, seminal vesicle involvement and lymph node and bone involvement. Incidental and significant findings seen on PSMA-PET/CT outside the PSMA-PET/MR field of view were also analysed. Agreements between PSMA-PET/CT and PSMA-PET/MR findings were performed using Cohen’s kappa test.
Results
Image analysis was performed on 140 patients (mean age, 67.3 ± 8.2 years). Agreement between PSMA PET/CT and PSMA-PET/MR was very good for intra-prostatic PSMA-avid foci (
K
= 0.85) and pelvic lymph nodes (
K
= 0.98), good for PSMA-avid bone metastases (
K
= 0.76) and fair for prostatic capsular invasion (
K
= 0.25) and seminal vesicle involvement (
K
= 0.31). Twelve patients (8.5%) had incidental findings and two patients (1.4%) had clinically significant findings.
Conclusion
Limited pelvic PSMA-PET/MR has very good agreement with PET/CT regarding PSMA-avid prostatic, regional lymph nodes and bone lesions, and is superior to PET/CT with regard to capsular invasion and seminal vesicle involvement.
Key Points
• Limited pelvic PSMA-PET/MR is superior to whole-body PSMA-PET/CT in detecting extensions of localised disease, mainly due to the high soft tissue resolution of MR.
• Limited pelvic PSMA-PET/MR may be useful for initial evaluation of histological biopsy-proven prostate cancer.
• Further studies are warranted to evaluate limited pelvic PSMA-PET/MR for screening and active surveillance in selected populations. |
| doi_str_mv | 10.1007/s00330-019-06353-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2321666694</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2321666694</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-281efb832dee1d919430daed66de09dae77f9c8e145d4f6ab31eb458770b9d773</originalsourceid><addsrcrecordid>eNp9UcFu1DAQtRAVXRZ-gAOyxIWL6dhO4phbtSq0UisqWM6WE09oqmwcbKdV_qCfXZctrcQBy5JH8948z8wj5B2HTxxAHUUAKYEB1wwqWUq2vCArXkjBONTFS7ICLWumtC4OyesYrwFA80K9IoeSSynKUq_I3cbvJhv66EfaYLpFHOmEw03f0ssfF8fs8mR7dPGd2tHR2ys_IGu8W56hzZZ2PtB0hbQf-9TbgeKNHWab-izoOzoFH5NNSFs7thg-U_uQykC-rc-pKdGYZre8IQedHSK-fXzX5OeXk-3mlJ1_-3q2OT5nrVRlYqLm2DW1FA6RO811IcFZdFXlEHSOlOp0WyMvSld0lW0kx6Yoa6Wg0U4puSYf97q5jd8zxmR2fWxxGOyIfo5GSMGrfLLwmnz4h3rt5zDm7owQFde1ygvOLLFntXnUGLAzU-h3NiyGg3nwyex9Mtkn88cns-Si94_Sc7ND91Ty15hMkHtCzND4C8Pz3_-RvQffJZ4F</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261987093</pqid></control><display><type>article</type><title>Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Domachevsky, Liran ; Bernstine, Hanna ; Goldberg, Natalia ; Nidam, Meital ; Catalano, Onofrio A. ; Groshar, David</creator><creatorcontrib>Domachevsky, Liran ; Bernstine, Hanna ; Goldberg, Natalia ; Nidam, Meital ; Catalano, Onofrio A. ; Groshar, David</creatorcontrib><description>Objectives
Despite the advantages of prostate-specific membrane antigen (PSMA)-PET/MR over PSMA-PET/CT, its relatively long scanning time and suboptimal PET attenuation correction necessitate careful assessment of the most appropriate setting for this type of study. We assessed lesion agreement between PSMA-PET/MR and PSMA-PET/CT in patients undergoing initial evaluation of prostate cancer.
Methods
This was a prospective study of consecutive patients with histological biopsy-proven prostate cancer who underwent pelvic PSMA-PET/MR followed by whole-body PSMA-PET/CT. All conspicuous PSMA-avid foci were counted on PSMA-PET/CT and PSMA-PET/MR with CT or MR correlation. Analysis was performed for intra-prostatic lesions, capsular invasion, seminal vesicle involvement and lymph node and bone involvement. Incidental and significant findings seen on PSMA-PET/CT outside the PSMA-PET/MR field of view were also analysed. Agreements between PSMA-PET/CT and PSMA-PET/MR findings were performed using Cohen’s kappa test.
Results
Image analysis was performed on 140 patients (mean age, 67.3 ± 8.2 years). Agreement between PSMA PET/CT and PSMA-PET/MR was very good for intra-prostatic PSMA-avid foci (
K
= 0.85) and pelvic lymph nodes (
K
= 0.98), good for PSMA-avid bone metastases (
K
= 0.76) and fair for prostatic capsular invasion (
K
= 0.25) and seminal vesicle involvement (
K
= 0.31). Twelve patients (8.5%) had incidental findings and two patients (1.4%) had clinically significant findings.
Conclusion
Limited pelvic PSMA-PET/MR has very good agreement with PET/CT regarding PSMA-avid prostatic, regional lymph nodes and bone lesions, and is superior to PET/CT with regard to capsular invasion and seminal vesicle involvement.
Key Points
• Limited pelvic PSMA-PET/MR is superior to whole-body PSMA-PET/CT in detecting extensions of localised disease, mainly due to the high soft tissue resolution of MR.
• Limited pelvic PSMA-PET/MR may be useful for initial evaluation of histological biopsy-proven prostate cancer.
• Further studies are warranted to evaluate limited pelvic PSMA-PET/MR for screening and active surveillance in selected populations.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-019-06353-y</identifier><identifier>PMID: 31332559</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Agreements ; Antigens ; Antigens, Surface ; Attenuation ; Biopsy ; Bone lesions ; Bone Neoplasms - secondary ; Computed tomography ; Correlation analysis ; Diagnostic Radiology ; Disease control ; Evaluation ; Field of view ; Glutamate Carboxypeptidase II ; Humans ; Image analysis ; Image processing ; Imaging ; Internal Medicine ; Interventional Radiology ; Lesions ; Lymph nodes ; Lymphatic Metastasis ; Lymphatic system ; Magnetic Resonance ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Metastases ; Middle Aged ; Neoplasm Invasiveness ; Neuroradiology ; Nodes ; Pelvis - diagnostic imaging ; Pelvis - pathology ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography - methods ; Positron-Emission Tomography - methods ; Proof of Concept Study ; Prospective Studies ; Prostate cancer ; Prostatic Neoplasms - diagnostic imaging ; Prostatic Neoplasms - pathology ; Radiology ; Seminal vesicle ; Seminal Vesicles - pathology ; Soft tissues ; Tomography ; Ultrasound</subject><ispartof>European radiology, 2020, Vol.30 (1), p.328-336</ispartof><rights>European Society of Radiology 2019</rights><rights>European Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-281efb832dee1d919430daed66de09dae77f9c8e145d4f6ab31eb458770b9d773</citedby><cites>FETCH-LOGICAL-c375t-281efb832dee1d919430daed66de09dae77f9c8e145d4f6ab31eb458770b9d773</cites><orcidid>0000-0002-4675-0750</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-019-06353-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-019-06353-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31332559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Domachevsky, Liran</creatorcontrib><creatorcontrib>Bernstine, Hanna</creatorcontrib><creatorcontrib>Goldberg, Natalia</creatorcontrib><creatorcontrib>Nidam, Meital</creatorcontrib><creatorcontrib>Catalano, Onofrio A.</creatorcontrib><creatorcontrib>Groshar, David</creatorcontrib><title>Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
Despite the advantages of prostate-specific membrane antigen (PSMA)-PET/MR over PSMA-PET/CT, its relatively long scanning time and suboptimal PET attenuation correction necessitate careful assessment of the most appropriate setting for this type of study. We assessed lesion agreement between PSMA-PET/MR and PSMA-PET/CT in patients undergoing initial evaluation of prostate cancer.
Methods
This was a prospective study of consecutive patients with histological biopsy-proven prostate cancer who underwent pelvic PSMA-PET/MR followed by whole-body PSMA-PET/CT. All conspicuous PSMA-avid foci were counted on PSMA-PET/CT and PSMA-PET/MR with CT or MR correlation. Analysis was performed for intra-prostatic lesions, capsular invasion, seminal vesicle involvement and lymph node and bone involvement. Incidental and significant findings seen on PSMA-PET/CT outside the PSMA-PET/MR field of view were also analysed. Agreements between PSMA-PET/CT and PSMA-PET/MR findings were performed using Cohen’s kappa test.
Results
Image analysis was performed on 140 patients (mean age, 67.3 ± 8.2 years). Agreement between PSMA PET/CT and PSMA-PET/MR was very good for intra-prostatic PSMA-avid foci (
K
= 0.85) and pelvic lymph nodes (
K
= 0.98), good for PSMA-avid bone metastases (
K
= 0.76) and fair for prostatic capsular invasion (
K
= 0.25) and seminal vesicle involvement (
K
= 0.31). Twelve patients (8.5%) had incidental findings and two patients (1.4%) had clinically significant findings.
Conclusion
Limited pelvic PSMA-PET/MR has very good agreement with PET/CT regarding PSMA-avid prostatic, regional lymph nodes and bone lesions, and is superior to PET/CT with regard to capsular invasion and seminal vesicle involvement.
Key Points
• Limited pelvic PSMA-PET/MR is superior to whole-body PSMA-PET/CT in detecting extensions of localised disease, mainly due to the high soft tissue resolution of MR.
• Limited pelvic PSMA-PET/MR may be useful for initial evaluation of histological biopsy-proven prostate cancer.
• Further studies are warranted to evaluate limited pelvic PSMA-PET/MR for screening and active surveillance in selected populations.</description><subject>Aged</subject><subject>Agreements</subject><subject>Antigens</subject><subject>Antigens, Surface</subject><subject>Attenuation</subject><subject>Biopsy</subject><subject>Bone lesions</subject><subject>Bone Neoplasms - secondary</subject><subject>Computed tomography</subject><subject>Correlation analysis</subject><subject>Diagnostic Radiology</subject><subject>Disease control</subject><subject>Evaluation</subject><subject>Field of view</subject><subject>Glutamate Carboxypeptidase II</subject><subject>Humans</subject><subject>Image analysis</subject><subject>Image processing</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Magnetic Resonance</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neuroradiology</subject><subject>Nodes</subject><subject>Pelvis - diagnostic imaging</subject><subject>Pelvis - pathology</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Positron Emission Tomography Computed Tomography - methods</subject><subject>Positron-Emission Tomography - methods</subject><subject>Proof of Concept Study</subject><subject>Prospective Studies</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - diagnostic imaging</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Radiology</subject><subject>Seminal vesicle</subject><subject>Seminal Vesicles - pathology</subject><subject>Soft tissues</subject><subject>Tomography</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9UcFu1DAQtRAVXRZ-gAOyxIWL6dhO4phbtSq0UisqWM6WE09oqmwcbKdV_qCfXZctrcQBy5JH8948z8wj5B2HTxxAHUUAKYEB1wwqWUq2vCArXkjBONTFS7ICLWumtC4OyesYrwFA80K9IoeSSynKUq_I3cbvJhv66EfaYLpFHOmEw03f0ssfF8fs8mR7dPGd2tHR2ys_IGu8W56hzZZ2PtB0hbQf-9TbgeKNHWab-izoOzoFH5NNSFs7thg-U_uQykC-rc-pKdGYZre8IQedHSK-fXzX5OeXk-3mlJ1_-3q2OT5nrVRlYqLm2DW1FA6RO811IcFZdFXlEHSOlOp0WyMvSld0lW0kx6Yoa6Wg0U4puSYf97q5jd8zxmR2fWxxGOyIfo5GSMGrfLLwmnz4h3rt5zDm7owQFde1ygvOLLFntXnUGLAzU-h3NiyGg3nwyex9Mtkn88cns-Si94_Sc7ND91Ty15hMkHtCzND4C8Pz3_-RvQffJZ4F</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Domachevsky, Liran</creator><creator>Bernstine, Hanna</creator><creator>Goldberg, Natalia</creator><creator>Nidam, Meital</creator><creator>Catalano, Onofrio A.</creator><creator>Groshar, David</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4675-0750</orcidid></search><sort><creationdate>2020</creationdate><title>Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study</title><author>Domachevsky, Liran ; Bernstine, Hanna ; Goldberg, Natalia ; Nidam, Meital ; Catalano, Onofrio A. ; Groshar, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-281efb832dee1d919430daed66de09dae77f9c8e145d4f6ab31eb458770b9d773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Agreements</topic><topic>Antigens</topic><topic>Antigens, Surface</topic><topic>Attenuation</topic><topic>Biopsy</topic><topic>Bone lesions</topic><topic>Bone Neoplasms - secondary</topic><topic>Computed tomography</topic><topic>Correlation analysis</topic><topic>Diagnostic Radiology</topic><topic>Disease control</topic><topic>Evaluation</topic><topic>Field of view</topic><topic>Glutamate Carboxypeptidase II</topic><topic>Humans</topic><topic>Image analysis</topic><topic>Image processing</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lesions</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Magnetic Resonance</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neuroradiology</topic><topic>Nodes</topic><topic>Pelvis - diagnostic imaging</topic><topic>Pelvis - pathology</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Positron Emission Tomography Computed Tomography - methods</topic><topic>Positron-Emission Tomography - methods</topic><topic>Proof of Concept Study</topic><topic>Prospective Studies</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - diagnostic imaging</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Radiology</topic><topic>Seminal vesicle</topic><topic>Seminal Vesicles - pathology</topic><topic>Soft tissues</topic><topic>Tomography</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Domachevsky, Liran</creatorcontrib><creatorcontrib>Bernstine, Hanna</creatorcontrib><creatorcontrib>Goldberg, Natalia</creatorcontrib><creatorcontrib>Nidam, Meital</creatorcontrib><creatorcontrib>Catalano, Onofrio A.</creatorcontrib><creatorcontrib>Groshar, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Domachevsky, Liran</au><au>Bernstine, Hanna</au><au>Goldberg, Natalia</au><au>Nidam, Meital</au><au>Catalano, Onofrio A.</au><au>Groshar, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2020</date><risdate>2020</risdate><volume>30</volume><issue>1</issue><spage>328</spage><epage>336</epage><pages>328-336</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
Despite the advantages of prostate-specific membrane antigen (PSMA)-PET/MR over PSMA-PET/CT, its relatively long scanning time and suboptimal PET attenuation correction necessitate careful assessment of the most appropriate setting for this type of study. We assessed lesion agreement between PSMA-PET/MR and PSMA-PET/CT in patients undergoing initial evaluation of prostate cancer.
Methods
This was a prospective study of consecutive patients with histological biopsy-proven prostate cancer who underwent pelvic PSMA-PET/MR followed by whole-body PSMA-PET/CT. All conspicuous PSMA-avid foci were counted on PSMA-PET/CT and PSMA-PET/MR with CT or MR correlation. Analysis was performed for intra-prostatic lesions, capsular invasion, seminal vesicle involvement and lymph node and bone involvement. Incidental and significant findings seen on PSMA-PET/CT outside the PSMA-PET/MR field of view were also analysed. Agreements between PSMA-PET/CT and PSMA-PET/MR findings were performed using Cohen’s kappa test.
Results
Image analysis was performed on 140 patients (mean age, 67.3 ± 8.2 years). Agreement between PSMA PET/CT and PSMA-PET/MR was very good for intra-prostatic PSMA-avid foci (
K
= 0.85) and pelvic lymph nodes (
K
= 0.98), good for PSMA-avid bone metastases (
K
= 0.76) and fair for prostatic capsular invasion (
K
= 0.25) and seminal vesicle involvement (
K
= 0.31). Twelve patients (8.5%) had incidental findings and two patients (1.4%) had clinically significant findings.
Conclusion
Limited pelvic PSMA-PET/MR has very good agreement with PET/CT regarding PSMA-avid prostatic, regional lymph nodes and bone lesions, and is superior to PET/CT with regard to capsular invasion and seminal vesicle involvement.
Key Points
• Limited pelvic PSMA-PET/MR is superior to whole-body PSMA-PET/CT in detecting extensions of localised disease, mainly due to the high soft tissue resolution of MR.
• Limited pelvic PSMA-PET/MR may be useful for initial evaluation of histological biopsy-proven prostate cancer.
• Further studies are warranted to evaluate limited pelvic PSMA-PET/MR for screening and active surveillance in selected populations.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31332559</pmid><doi>10.1007/s00330-019-06353-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4675-0750</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2020, Vol.30 (1), p.328-336 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2321666694 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Agreements Antigens Antigens, Surface Attenuation Biopsy Bone lesions Bone Neoplasms - secondary Computed tomography Correlation analysis Diagnostic Radiology Disease control Evaluation Field of view Glutamate Carboxypeptidase II Humans Image analysis Image processing Imaging Internal Medicine Interventional Radiology Lesions Lymph nodes Lymphatic Metastasis Lymphatic system Magnetic Resonance Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Metastases Middle Aged Neoplasm Invasiveness Neuroradiology Nodes Pelvis - diagnostic imaging Pelvis - pathology Positron emission Positron emission tomography Positron Emission Tomography Computed Tomography - methods Positron-Emission Tomography - methods Proof of Concept Study Prospective Studies Prostate cancer Prostatic Neoplasms - diagnostic imaging Prostatic Neoplasms - pathology Radiology Seminal vesicle Seminal Vesicles - pathology Soft tissues Tomography Ultrasound |
| title | Comparison between pelvic PSMA-PET/MR and whole-body PSMA-PET/CT for the initial evaluation of prostate cancer: a proof of concept study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T11%3A49%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparison%20between%20pelvic%20PSMA-PET/MR%20and%20whole-body%20PSMA-PET/CT%20for%20the%20initial%20evaluation%20of%20prostate%20cancer:%20a%20proof%20of%20concept%20study&rft.jtitle=European%20radiology&rft.au=Domachevsky,%20Liran&rft.date=2020&rft.volume=30&rft.issue=1&rft.spage=328&rft.epage=336&rft.pages=328-336&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-019-06353-y&rft_dat=%3Cproquest_cross%3E2321666694%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2261987093&rft_id=info:pmid/31332559&rfr_iscdi=true |