Comparison of 68Ga-PSMA-11 PET-CT with mpMRI for preoperative lymph node staging in patients with intermediate to high-risk prostate cancer

Journal of Translational Medicine

Research

Chuan Zhang¹  Rui Luo¹  Shiming Zang¹  Feng Wang¹  Yao Fu²  Qinglei Zhang³  Yongming Deng⁴  Wei Wang⁴  Hongqian Guo⁴  Chengwei Zhang⁴  Xiaozhi Zhao⁴  Qing Zhang⁴  Xiaoyu Lv⁴ 

[1] Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, 210006, Nanjing, China;Department of Pathology, Drum Tower Hospital, Medical School of Nanjing University, 210008, Nanjing, Jiangsu, People’s Republic of China;Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, 210008, Nanjing, Jiangsu, People’s Republic of China;Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, 321 Zhongshan Rd., 210008, Nanjing, Jiangsu, People’s Republic of China;

关键词: Prostate cancer;    PSMA;    PET-CT;    mpMRI;    Lymph node staging;   

DOI  :  10.1186/s12967-017-1333-2

 received in 2017-08-21, accepted in 2017-10-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTo evaluate the diagnostic value of 68Ga-PSMA-11 PET-CT with multiparametric magnetic resonance imaging (mpMRI) for lymph node (LN) staging in patients with intermediate- to high-risk prostate cancer (PCa) undergoing radical prostatectomy (RP) with pelvic lymph node dissection (PLND).MethodsWe retrospectively identified 42 consecutive patients with intermediate- to high-risk PCa according to D′Amico and without concomitant cancer. Preoperative 68Ga-PSMA-11 PET-CT, pelvic mpMRI and subsequent robot assisted laparoscopic RP with PLND were performed in all patients.ResultsAmong 42 patients assessed, the preoperative PSA value, Gleason score, pT stage and intraprostatic PCa volume of patients with LN metastases were all significantly higher than those without metastases (P = 0.029, 0.028, 0.004, respectively). The average maximum standardized uptake value (SUV) of 68Ga-PSMA-11 PET-CT positive PCa of patients with or without LN metastases were 13.10 (range 6.12–51.75) and 7.22 (range 5.4–11.2), respectively (P < 0.001). 68Ga-PSMA-11 PET-CT and pelvic mpMRI had the ability of succeed on preoperative definite accurate diagnosis and accurate localization of primary PCa in all 42 patients. Fifteen patients (35.71%) had a pN1 stage. 51 positive LN were found. Both 68Ga-PSMA-11 PET-CT and pelvic mpMRI displayed brillient patient-based and region-based sensitivity, specificity, negative predictive value and positive predictive value. There was no statistical difference for the detection of LNMs according to the diameter of the LNMs between 68Ga-PSMA-11 PET-CT and mpMRI in this study.ConclusionsBoth 68Ga-PSMA-11 PET-CT and mpMRI performed great value for LN staging in patients with intermediate- to high-risk PCa undergoing RP with PLND. However, despite excellent performance of 68Ga-PSMA-11 PET-CT, it cannot replace mpMRI that remains excellent for lymph node staging.

【 授权许可】

CC BY   
© The Author(s) 2017