Whole-body low-dose CT can be of value in prostate cancer decision-making: a retrospective study on 601 patients

Insights into Imaging

Original Article

Seyed Asadollah Mousavi¹  Mohammadreza Chavoshi²  Babak Fallahi³  Amir Reza Radmard⁴  Seyed Ali Mirshahvalad⁵  Sara Zamani⁶ 

[1]Department of Hematology-Oncology, Hematology-Oncology and BMT Research Center/Tehran University of Medical Sciences, Tehran, Iran

[2]Department of Hematology-Oncology, Hematology-Oncology and BMT Research Center/Tehran University of Medical Sciences, Tehran, Iran

[3]Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

[4]Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

[5]Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

[6]Joint Department of Medical Imaging (JDMI), University Medical Imaging Toronto (UMIT), University Health Network, Mount Sinai Hospital and Women’s College Hospital, University of Toronto, Toronto, ON, Canada

[7]Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

[8]School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

关键词: Prostate;    Computed tomography;    Bone;    Metastasis;    Ga-PSMA;   

DOI  :  10.1186/s13244-023-01475-w

 received in 2023-05-03, accepted in 2023-07-03,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesTo evaluate the diagnostic value of whole-body low-dose computed tomography (CT) to detect bone metastasis in prostate cancer (PCa) patients and its possible utility in therapeutic decision-making. Also, to determine the valuable CT features for lesion characterisation.MethodsThis IRB-approved retrospective study reviewed PCa patients who underwent 68Ga-PSMA PET/CT in our centre from March 2017 to August 2022. Two board-certified radiologists and one nuclear medicine specialist reported all whole-body low-dose CT scans separately, unaware of the 68Ga-PSMA-PET results. The per-lesion and per-patient diagnostic performances were calculated. Also, the significance of CT features was evaluated. Moreover, the inter-observer agreement was analysed. A two-tailed p value < 0.05 was considered significant.ResultsFrom 727 reviewed PCa patients, 601 (mean age = 68.7 ± 8.1) were found to be eligible, including 211 (35.1%) referrals for initial staging and 390 (64.9%) for evaluating the extent of the disease after biochemical recurrence. Per-patient diagnostic analysis for three reviewers showed 81.0–89.4% sensitivity and 96.6–98.5% specificity in detecting osteo-metastasis. It was able to correctly detect high-burden disease based on both CHAARTED and LATITUDE criteria. Regarding the value of underlying CT features, size > 1 cm, ill-defined borders, presence of soft-tissue component, and cortical destruction were statistically in favour of metastasis. Also, Hu > 900 was in favour of benign entities with 93% specificity.ConclusionsAlthough not as accurate as 68Ga-PSMA PET/CT, whole-body low-dose CT might precisely classify PCa patients considering therapeutic decision-making. Additionally, we proposed diagnostic CT features that could help radiologists with better characterisation of the detected lesions.Critical relevance statementThe whole-body low-dose CT can be considered valuable in the clinical decision-making of prostate cancer patients. This modality may obviate performing multiple imaging sessions and high-cost scans in patients diagnosed with the high-burden disease.Graphical abstract

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 7

12938_2023_1124_Article_IEq11.gif

12938_2023_1124_Article_IEq9.gif

Fig.3

Fig. 7

Fig. 1

Fig. 6