Intraindividual Comparison of 18F-PSMA-1007 PET/CT, Multiparametric MRI, and Radical Prostatectomy Specimens in Patients with Primary Prostate Cancer: A Retrospective, Proof-of-Concept Study
Intraindividual Comparison of 18F-PSMA-1007 PET/CT, Multiparametric MRI, and Radical Prostatectomy Specimens in Patients with Primary Prostate Cancer: A Retrospective, Proof-of-Concept Study
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DOI：
10.2967/jnumed.116.189233
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发表时间：
2017-11-01
影响因子：
9.3
通讯作者：
Giesel, Frederik L.
中科院分区：
文献类型：
--
作者：
Kesch, Claudia;Vinsensia, Maria;Giesel, Frederik L.
Ga-68-前列腺特异性膜抗原 (PSMA)-11 PET/CT 代表了原发性前列腺癌 (PCa) 分期和复发性或转移性 PCa 诊断的先进方法。然而，由于 Ga-68 的可用性有限，替代示踪剂的开发引起了人们的高度关注。本研究的目的是通过将新型 PET 示踪剂 F-18-PSMA-1007 与多参数 MRI (mpMRI) 和根治性前列腺切除术 (RP) 组织病理学进行比较，探讨其对局部疾病分期的价值。方法：2016 年，对 10 名活检确诊为高危 PCa 的男性进行了 F-18-PSMA-1007 PET/CT。 9 名患者在初步诊断过程中接受了 mpMRI。连续对所有 10 名男性进行了 RP。回顾性地进行了一致性分析。对 RP 标本切片中的代表性切片添加 PSMA 染色。 F-18-PSMA-1007 PET/CT、mpMRI 和 RP 标本的定位和一致性分析是通过将前列腺分为 38 个部分来进行的，如前列腺成像报告和数据系统 (PI-RADS)（版本 2）中所述。计算灵敏度、特异性、阳性预测值、阴性预测值 (NPV) 和准确度，以获得完全和接近完全一致性。结果：F-18-PSMA-1007 PET/CT 的 NPV 为 68%，准确度为 75%，mpMRI 的 NPV 为 88%，准确度为 73%，总体一致。近乎完全一致的分析结果显示，F-18-PSMA-1007 PET/CT 的 NPV 为 91%，准确度为 93%，mpMRI 的 NPV 为 91%，准确度为 87%。 mpMRI 和 PET/CT 的回顾性组合的总体准确率为 81%，接近完全一致的准确率为 93%。结论：与 RP 组织病理学的比较表明，F-18-PSMA-1007 PET/CT 有望用于 PCa 的准确局部分期。
Ga-68-prostate-specific membrane antigen (PSMA)-11 PET/CT represents an advanced method for the staging of primary prostate cancer (PCa) and diagnosis of recurrent or metastatic PCa. However, because of the narrow availability of Ga-68 the development of alternative tracers is of high interest. The objective of this study was to examine the value of the new PET tracer F-18-PSMA-1007 for the staging of local disease by comparing it with multiparametric MRI (mpMRI) and radical prostatectomy (RP) histopathology. Methods: In 2016, F-18-PSMA-1007 PET/CT was performed in 10 men with biopsy-confirmed high-risk PCa. Nine patients underwent mpMRI in the process of primary diagnosis. Consecutively, RP was performed in all 10 men. Agreement analysis was performed retrospectively. PSMA staining was added for representative sections in RP specimen slices. Localization and agreement analysis of F-18-PSMA-1007 PET/CT, mpMRI, and RP specimens was performed by dividing the prostate into 38 sections as described in the prostate imaging reporting and data system (PI-RADS) (version 2). Sensitivity, specificity, positive predictive values, negative predictive values (NPVs), and accuracy were calculated for total and near-total agreement. Results: F-18-PSMA-1007 PET/CT had an NPV of 68% and an accuracy of 75%, and mpMRI had an NPV of 88% and an accuracy of 73% for total agreement. Near-total agreement analysis resulted in an NPV of 91% and an accuracy of 93% for F-18-PSMA-1007 PET/CT and 91% and 87% for mpMRI, respectively. Retrospective combination of mpMRI and PET/CT had an accuracy of 81% for total and 93% for near-total agreement. Conclusion: Comparison with RP histopathology demonstrates that F-18-PSMA-1007 PET/CT is promising for accurate local staging of PCa.