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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

11.01.2019 | Original Article

Diagnostic performance of ⁶⁸Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms

verfasst von: Jingliang Zhang, Shuai Shao, Peng Wu, Daliang Liu, Bo Yang, Donghui Han, Yu Li, Xiaoyu Lin, Wei Song, Milin Cao, Jing Zhang, Fei Kang, Weijun Qin, Jing Wang

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 4/2019

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Abstract

Purpose

To assess the diagnostic performance of ⁶⁸Ga-PSMA PET/CT for detecting suspected prostate cancer (PCa) and to compare it with that of two cancer-predicting nomograms.

Methods

We performed a retrospective analysis of 146 consecutive patients with suspected PCa based on symptoms or elevated total prostate-specific antigen (tPSA) levels who underwent ⁶⁸Ga-PSMA PET/CT and histopathologic examinations from April 2017 to April 2018 in a large tertiary care hospital in China. The ⁶⁸Ga-PSMA PET/CT results (PCa or benignancy) were evaluated by two experienced nuclear medicine specialists. The risk of positive PCa was evaluated using ERSPC and PCPT nomograms. The diagnostic performances of ⁶⁸Ga-PSMA PET/CT and that of the two nomograms were compared via receiver operating characteristic (ROC) curve analysis, decision curve analysis, and logistic regression.

Results

A total of 58 patients with tPSA of 0.4–50 ng/ml were included in the final analysis; PCa diagnosis was confirmed in 37 patients and excluded in 21 patients. ROC analysis showed that the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ⁶⁸Ga-PSMA PET/CT were 91.67, 81.82, 89.19, and 85.71%, respectively, in per-patient analyses. ⁶⁸Ga-PSMA PET/CT exhibited a higher AUC (0.867) than those of ERSPC-RC3 (0.855) and PCPT-RC (0.770). The net benefit of ⁶⁸Ga-PSMA PET/CT was greatest for patients within threshold probabilities of 15–90%. Among the 58 patients, 11 (19%) biopsies suggested by ERSPC-RC3 were unnecessary and could have been avoided if judged by the ⁶⁸Ga-PSMA PET/CT results. Multivariate analysis revealed that the maximum standardised uptake value (SUV_max) and prostate volume were significant predictive factors for positive PCa results.

Conclusion

In suspected PCa patients with tPSA of 0.4–50 ng/ml, ⁶⁸Ga-PSMA PET/CT outperformed the nomograms in predicting cancer and reducing unnecessary biopsies. In addition, the risk of PCa was positively correlated with a higher SUV_max and lower prostate volume, which could help clinicians in making preliminary estimates of individual cancer risk, monitoring ⁶⁸Ga-PSMA PET/CT false-positive results and making biopsy decisions in daily medical practice.

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Titel: Diagnostic performance of 68Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms
verfasst von: Jingliang Zhang
Shuai Shao
Peng Wu
Daliang Liu
Bo Yang
Donghui Han
Yu Li
Xiaoyu Lin
Wei Song
Milin Cao
Jing Zhang
Fei Kang
Weijun Qin
Jing Wang
Publikationsdatum: 11.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 4/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4255-1

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Diagnostic performance of ⁶⁸Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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