1
|
Giesel FL, Sterzing F, Schlemmer HP, Holland-Letz T, Mier W, Rius M, Afshar-Oromieh A, Kopka K, Debus J, Haberkorn U, Kratochwil C. Intra-individual comparison of (68)Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer. Eur J Nucl Med Mol Imaging 2016; 43:1400-6. [PMID: 26971788 PMCID: PMC4906063 DOI: 10.1007/s00259-016-3346-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/16/2016] [Indexed: 12/01/2022]
Abstract
Purpose Multi-parametric magnetic resonance imaging (MP-MRI) is currently the most comprehensive work up for non-invasive primary tumor staging of prostate cancer (PCa). Prostate-specific membrane antigen (PSMA)-Positron emission tomography–computed tomography (PET/CT) is presented to be a highly promising new technique for N- and M-staging in recurrent PCa-patients. The actual investigation analyses the potential of 68Ga-PSMA11-PET/CT to assess the extent of primary prostate cancer by intra-individual comparison to MP-MRI. Methods In a retrospective study, ten patients with primary PCa underwent MP-MRI and PSMA-PET/CT for initial staging. All tumors were proven histopathological by biopsy. Image analysis was done in a quantitative (SUVmax) and qualitative (blinded read) fashion based on PI-RADS. The PI-RADS schema was then translated into a 3D-matrix and the euclidian distance of this coordinate system was used to quantify the extend of agreement. Results Both MP-MRI and PSMA-PET/CT presented a good allocation of the PCa, which was also in concordance to the tumor location validated in eight-segment resolution by biopsy. An Isocontour of 50 % SUVmax in PSMA-PET resulted in visually concordant tumor extension in comparison to MP-MRI (T2w and DWI). For 89.4 % of sections containing a tumor according to MP-MRI, the tumor was also identified in total or near-total agreement (euclidian distance ≤1) by PSMA-PET. Vice versa for 96.8 % of the sections identified as tumor bearing by PSMA-PET the tumor was also found in total or near-total agreement by MP-MRI. Conclusions PSMA-PET/CT and MP-MRI correlated well with regard to tumor allocation in patients with a high pre-test probability for large tumors. Further research will be needed to evaluate its value in challenging situation such as prostatitis or after repeated negative biopsies.
Collapse
Affiliation(s)
- F L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany.
| | - F Sterzing
- Department of RadioOncology, University Hospital Heidelberg, Heidelberg, Germany
| | - H P Schlemmer
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Holland-Letz
- Department of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - W Mier
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - M Rius
- Institute of Transuranium Elements, European Commission (EC), Karlsruhe, Germany
| | - A Afshar-Oromieh
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - K Kopka
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Debus
- Department of RadioOncology, University Hospital Heidelberg, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Unit of Radiopharmaceutic Chemistry, German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|