Intra-individual comparison of (68)Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer.
Intra-individual comparison of (68)Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer.
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DOI：
10.1007/s00259-016-3346-0
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发表时间：
2016-07
影响因子：
9.1
通讯作者：
Kratochwil C
中科院分区：
文献类型：
--
作者：
Giesel FL;Sterzing F;Schlemmer HP;Holland-Letz T;Mier W;Rius M;Afshar-Oromieh A;Kopka K;Debus J;Haberkorn U;Kratochwil C
多参数磁共振成像（MP-MRI）是目前对前列腺癌（PCa）的非侵入性原发性肿瘤分期最全面的检查。前列腺特异性膜抗原（PSMA）-正电子发射断层扫描-计算机断层扫描（PET/CT）是一种非常有前途的新技术，用于复发性前列腺癌患者的N和M分期。实际研究分析了68 Ga-PSMA 11-PET/CT通过与MP-MRI进行个体内比较来评估原发性前列腺癌程度的潜力。在一项回顾性研究中，10例原发性PCa患者接受了MP-MRI和PSMA-PET/CT进行初始分期。所有肿瘤均经活检病理证实。基于PI-RADS以定量（SUVmax）和定性（盲读）方式进行图像分析。然后将PI-RADS模式转换为三维矩阵，并使用该坐标系的欧几里德距离来量化一致性的程度。MP-MRI和PSMA-PET/CT均显示了PCa的良好分布，这也与活检八段分辨率中验证的肿瘤位置一致。与MP-MRI（T2 w和DWI）相比，PSMA-PET中50% SUVmax的等轮廓线导致视觉上一致的肿瘤扩展。对于89.4%的包含肿瘤的切片（根据MP-MRI），PSMA-PET也以完全或接近完全一致（欧几里德距离≤1）识别出肿瘤。反之亦然，对于96.8%的通过PSMA-PET识别为肿瘤的切片，也发现肿瘤通过MP-MRI完全或接近完全一致。PSMA-PET/CT和MP-MRI与大肿瘤预检验概率高的患者的肿瘤分配相关性良好。需要进一步的研究来评估其在具有挑战性的情况下的价值，如前列腺炎或反复阴性活检后。
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. 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. 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. 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.