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03.09.2019 | Research Article

Whole-Body Integrated [⁶⁸Ga]PSMA-11-PET/MR Imaging in Patients with Recurrent Prostate Cancer: Comparison with Whole-Body PET/CT as the Standard of Reference

verfasst von: Nika Guberina, P. Hetkamp, H. Ruebben, W. Fendler, J. Grueneisen, S. Suntharalingam, J. Kirchner, L. Puellen, N. Harke, J. P. Radtke, L. Umutlu, B. A. Hadaschik, K. Herrmann, M. Forsting, A. Wetter

Erschienen in: Molecular Imaging and Biology | Ausgabe 3/2020

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Abstract

Purpose

The aim of this study was to evaluate the detection rate of [⁶⁸Ga]prostate-specific membrane antigen ([⁶⁸Ga]PSMA-11) positron emission tomography (PET)/magnetic resonance imaging (MRI) and to compare it with [⁶⁸Ga]PSMA-11 PET/X-ray computed tomography (CT) in patients with recurrent prostate cancer (PC) after radical prostatectomy.

Procedures

A total of 93 patients with biochemically recurrent prostate cancer underwent [⁶⁸Ga]PSMA-11 PET/CT and subsequently a whole-body integrated PET/MRI examination. Board certified nuclear medicine physicians and radiologists evaluated PET/CT and PET/MRI datasets regarding identification of tumor lesions ((i) lymph nodes, (ii) bone lesions, (iii) local recurrence, and (iv) parenchymal lesions) based on maximum [⁶⁸Ga]PSMA-11 uptake as well as morphological changes. Quality of PET images for both PET/CT and PET/MRI were rated using a 5-point scoring system by evaluating lesion homogeneity, contrast, contour, and delineation. Wilcoxon signed-rank tests were used to determine statistical differences.

Results

PC relapse was detected in 62/93 patients. PET/MRI detected 148 out of 150 lesions described in PET/CT. In addition, PET/MRI detected 11 lesions not detected in PET/CT (5 lymph nodes, 6 local recurrences). The exact McNemar statistical test (one-sided) showed significant difference between PET/CT and PET/MRI for diagnosis of local recurrence (p value = 0.031). Diagnostic confidence for (iii) was higher in PET/MRI compared with PET/CT (PET/CT = 1.1; PET/MRI = 4.9). Diagnostic confidence for (i) (PET/CT = 4.9; PET/MRI = 4.6), (ii) (PET/CT = 4.9; PET/MRI = 4.6), and (iv) (PET/CT = 4.6; PET/MRI = 4.8) was equivalent between PET/MRI and PET/CT.

Conclusions

Integrated [⁶⁸Ga]PSMA-11 PET/MRI provides a similarly high diagnostic performance for localization of recurrent PC as PET/CT. For the detection of local recurrences [⁶⁸Ga]PSMA-11 PET/MRI is superior compared with [⁶⁸Ga]PSMA-11 PET/CT.

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Titel: Whole-Body Integrated [68Ga]PSMA-11-PET/MR Imaging in Patients with Recurrent Prostate Cancer: Comparison with Whole-Body PET/CT as the Standard of Reference
verfasst von: Nika Guberina
P. Hetkamp
H. Ruebben
W. Fendler
J. Grueneisen
S. Suntharalingam
J. Kirchner
L. Puellen
N. Harke
J. P. Radtke
L. Umutlu
B. A. Hadaschik
K. Herrmann
M. Forsting
A. Wetter
Publikationsdatum: 03.09.2019
Verlag: Springer International Publishing
Erschienen in: Molecular Imaging and Biology / Ausgabe 3/2020
Print ISSN: 1536-1632
Elektronische ISSN: 1860-2002
DOI: https://doi.org/10.1007/s11307-019-01424-4

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Whole-Body Integrated [⁶⁸Ga]PSMA-11-PET/MR Imaging in Patients with Recurrent Prostate Cancer: Comparison with Whole-Body PET/CT as the Standard of Reference

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Purpose

Procedures

Results

Conclusions

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