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Nuclear Medicine and Molecular Imaging
Erschienen in: Nuclear Medicine and Molecular Imaging 4/2017

07.03.2017 | Original Article

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

verfasst von: Christoph-Alexander J. von Klot, Axel S. Merseburger, Alena Böker, Sebastian Schmuck, Tobias L. Ross, Frank M. Bengel, Markus A. Kuczyk, Christoph Henkenberens, Hans Christiansen, Hans-Jürgen Wester, Wiebke Solass, Marcel Lafos, Thorsten Derlin

Erschienen in: Nuclear Medicine and Molecular Imaging | Ausgabe 4/2017

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Abstract

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 (r s = 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 (r p = 0.75, p < 0.001) and tumor volume on histopathology (r p = 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.
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Metadaten
Titel
68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer
verfasst von
Christoph-Alexander J. von Klot
Axel S. Merseburger
Alena Böker
Sebastian Schmuck
Tobias L. Ross
Frank M. Bengel
Markus A. Kuczyk
Christoph Henkenberens
Hans Christiansen
Hans-Jürgen Wester
Wiebke Solass
Marcel Lafos
Thorsten Derlin
Publikationsdatum
07.03.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Nuclear Medicine and Molecular Imaging / Ausgabe 4/2017
Print ISSN: 1869-3474
Elektronische ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-017-0476-7

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