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European Journal of Nuclear Medicine and Molecular Imaging

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16.03.2019 | Original Article

Prospective comparison of whole-body MRI and ⁶⁸Ga-PSMA PET/CT for the detection of biochemical recurrence of prostate cancer after radical prostatectomy

verfasst von: Lino M. Sawicki, Julian Kirchner, Carolin Buddensieck, Christina Antke, Tim Ullrich, Lars Schimmöller, Johannes Boos, Christoph Schleich, Benedikt M. Schaarschmidt, Christian Buchbender, Philipp Heusch, Robert Rabenalt, Peter Albers, Gerald Antoch, Hans-Wilhelm Müller, Hubertus Hautzel

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2019

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Abstract

Purpose

To assess whole-body magnetic resonance imaging (wb-MRI) for detection of biochemical recurrence in comparison to ⁶⁸Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga-PSMA PET/CT) in prostate cancer (Pca) patients after radical prostatectomy.

Methods

This was a prospective trial including 28 consecutive patients (mean age 65.3 ± 9.0 years) with newly documented biochemical recurrence of Pca (mean prostate-specific antigen, PSA, 2.09 ± 1.95 ng/ml) following radical prostatectomy. All patients underwent both wb-MRI including a dedicated pelvic imaging protocol and PET/CT with 166 ± 35 MBq ⁶⁸Ga-PSMA within a time window of 11 ± 10 days. PET/CT and MRI datasets were separately evaluated regarding Pca lesion count, type, localization and diagnostic confidence (three-point Likert scale, 1–3) by two nuclear medicine specialists and two radiologists, respectively. The reference standard was based on histopathological results, PSA levels following targeted salvage irradiation and follow-up imaging. Lesion-based and patient-based detection rates were compared using the chi-squared test. Differences in diagnostic confidence were assessed using the Welch test.

Results

A total of 56 Pca lesions were detected in 20 of the 28 patients. ⁶⁸Ga-PSMA PET/CT detected 56 of 56 lesions (100%) in 20 patients (71.4%), while wb-MRI detected 13 lesions (23.2%) in 11 patients (39.3%). The higher detection rate with ⁶⁸Ga-PSMA PET/CT was statistically significant on both a per-lesion basis (p < 0.001) and a per-patient basis (p = 0.0167). In 8 patients (28.6%) no relapse was detectable by either modality. All lesions detected by wb-MRI were also detected by ⁶⁸Ga-PSMA PET/CT. Additionally, ⁶⁸Ga-PSMA PET/CT provided superior diagnostic confidence in identifying Pca lesions (2.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.044).

Conclusion

⁶⁸Ga-PSMA PET/CT significantly out-performed wb-MRI in the detection of biochemical recurrence in Pca patients after radical prostatectomy.

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Titel: Prospective comparison of whole-body MRI and 68Ga-PSMA PET/CT for the detection of biochemical recurrence of prostate cancer after radical prostatectomy
verfasst von: Lino M. Sawicki
Julian Kirchner
Carolin Buddensieck
Christina Antke
Tim Ullrich
Lars Schimmöller
Johannes Boos
Christoph Schleich
Benedikt M. Schaarschmidt
Christian Buchbender
Philipp Heusch
Robert Rabenalt
Peter Albers
Gerald Antoch
Hans-Wilhelm Müller
Hubertus Hautzel
Publikationsdatum: 16.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04308-5

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Prospective comparison of whole-body MRI and ⁶⁸Ga-PSMA PET/CT for the detection of biochemical recurrence of prostate cancer after radical prostatectomy

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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