Validation of 18 F-rhPSMA-7 and 18 F-rhPSMA-7.3 PET Imaging Results with Histopathology from Salvage Surgery in Patients with Biochemical Recurrence of Prostate Cancer

The Journal of Nuclear Medicine

article

Markus Kroenke¹  Lilit Schweiger¹  Thomas Horn²  Bernhard Haller³  Kristina Schwamborn⁴  Alexander Wurzer¹  Tobias Maurer⁶  Hans-Jürgen Wester⁵  Matthias Eiber¹  Isabel Rauscher¹ 

[1] Department of Nuclear Medicine, School of Medicine, Technical University of Munich;Department of Urology, School of Medicine, Technical University of Munich;Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich;Department of Pathology, School of Medicine, Technical University of Munich;Chair of Radiopharmacy, School of Medicine, Technical University of Munich;Martini-Klinik and Department of Urology, University Hospital Hamburg-Eppendorf

关键词: 18F-rhPSMA-7;    18F-rhPSMA-7.3;    prostate cancer;    salvage surgery;    biochemical recurrence;    prostate-specific membrane antigen;   

DOI  :  10.2967/jnumed.121.263707

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

18F-rhPSMA-7, and its single diastereoisomer form, 18F-rhPSMA-7.3, are prostate-specific membrane antigen (PSMA)–targeting radiopharmaceuticals. Here, we investigated their accuracy for the assessment of lymph node (LN) metastases validated by histopathology. Methods: Data from 58 patients with biochemical recurrence of prostate cancer after radical prostatectomy receiving salvage surgery after PET imaging with 18F-rhPSMA-7 or 18F-rhPSMA-7.3 were retrospectively reviewed. Two nuclear medicine physicians reviewed all PET scans and morphologic imaging in consensus. Readers were masked from the results of histopathology. PET and morphologic imaging were correlated with histopathology from resected LNs. Results: In 75 of 150 resected regions in 54 of 58 patients, tumor lesions were present in histopathology. The template-based specificity of PET (18F-rhPSMA-7 and 18F-rhPSMA-7.3 combined) and morphologic imaging was 93.3% and 100%, respectively. However, 18F-rhPSMA-7 and 18F-rhPSMA-7.3 PET detected metastases in 61 of 75 histopathologically proven metastatic LN fields (81.3%) whereas morphologic imaging was positive in only 9 of 75 (12.0%). The positive predictive value was 92.4% for 18F-rhPSMA-7 and 18F-rhPSMA-7.3 PET and 100% for morphologic imaging. 18F-rhPSMA-7 and 18F-rhPSMA-7.3 PET performance was significantly superior to morphologic imaging (difference in the areas under the receiver-operating-characteristic curves, 0.222; 95% CI, 0.147–0.298; P < 0.001). The mean size of PET-positive and histologically confirmed LN metastases was 6.3 ± 3.1 mm (range, 2–15 mm) compared with a mean size of 9.8 ± 2.5 mm (range, 7–15 mm) on morphologic imaging. Conclusion: 18F-rhPSMA-7 and 18F-rhPSMA-7.3 PET offer a high positive predictive value comparable to that reported for 68Ga-PSMA-11 and represent a valuable tool for guiding salvage lymphadenectomy.

【 授权许可】

CC BY