Comparison of preoperative locoregional Ga‐68 PSMA‐11 PET‐CT and mp‐MRI results with postoperative histopathology of prostate cancer

Abstract

Background: Conventional imaging modalities are inadequate to evaluate locoregional extension of prostate cancer (PCa). The aim of the current retrospective study was to investigate the diagnostic efficacy of Gallium-68 prostate-specific membrane antigen-11 (Ga-68 PSMA-11) positron emission tomography/computed tomography (PET/CT) and multiparametric magnetic resonance imaging (mp-MRI) for staging preoperative PCa patients with correlating histopathology. Materials and Methods:Twenty-four patients with histologically proven PCa underwent both Ga-68 PSMA-11 PET/CT and mp-MRI before robot-assisted laparoscopic radical prostatectomy. For each tumor area, correlations with histopathological results were defined for tumor localization, extraprostatic extension (EPE) of the tumor, invasion of seminal vesicle (SVI) and bladder neck invasion (BNI). In patients with regional lymph node (LN) dissection, histopathological results were also correlated with imaging modalities.Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of EPE and SVI were higher for mp-MRI than Ga-68 PSMA-11 PET/CT. On the other hand Ga-68 PSMA-11 PET/CT had significant successful results for detection of LN metastases when compared with mp-MRI. But for BNI detection both modalities had same insufficient results. Ga-68 PSMA-11 PET/ CT had strong results for appropriate tumor localization in the gland. Conclusion: Ga-68 PSMA PET/CT has superior results for assessing local LN metastases and for intraprostatic tumor localization. Whereas, mp-MRI must be the preferred modality for determining SVI and EPE. But both imaging modalities failed for determining BNI accurately. Both modalities should be used in conjunction with each other for better treatment planning. K E Y W O R D S extraprostatic extension, Gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography, lymph node, multiparametric magnetic resonance imaging, prostate cancer, seminal vesicle The Prostate. 2019;79:1007-1017. wileyonlinelibrary.com/journal/pros

Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

“…The results of this review highlight the high specificity and positive predictive value of 68 Ga-PSMA PET in detecting pelvic lymph node metastases. Most studies report a perpatient specificity of 90% or higher [10,11,13,[15][16][17]19]. This high specificity is a result of the high expression of PSMA in PCa and lymph node metastases, resulting in a high tumour to background ratio [46][47][48][49].…”

“…Eleven studies were included in this review that presented data on the sensitivity and specificity of 68 Ga-PSMA PET for detection of pelvic lymph node metastases in men with newly diagnosed PCa (Table 1, Fig. 1) [8, [10][11][12][13][14][15][16][17][18][19]. Two prospective studies, including a total of 63 patients, showed a per-patient sensitivity (range) and specificity (range) of 64-100% and 90-95%, respectively.…”

Can 68Ga-prostate specific membrane antigen positron emission tomography / computerized tomography provide an accurate lymph node staging for patients with medium / high risk prostate cancer? A Diagnostic Meta-Analysis

“…Among them,20 received primaryPLND and 14 received secondary PLND, which maybe the main reasonfor the lower speci city. Multi-parametermagnetic resonance(mpMR) also plays a large role in thepreoperative evaluation ofprostate cancer, especially in judgingextraprostatic extension(EPE) of the tumor, invasion of the seminalvesicle(SVI) [20]. In aretrospective study by Van Leeuwen atal.…”

“…Through full-text analysis and assessment ofeligibility,42 articles that were not related to diagnostic value,12 articlesthat were no related to LN staging, and 6 studies thathad noaccess data. Finally, we included 10 studies inourmeta-analysis [2,9,10,[17][18][19][20][21][22][23].…”

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of Prostate Cancer: A Systematic Review and Meta-Analysis

“…All authors read and approved the nal manuscript. [27] and Yilmaz et al [37], respectively. Table 2.…”