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Prospective evaluation of the performance of [68Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy

Abufaraj, Mohammad ; Grubmüller, Bernhard ; Zeitlinger, Markus ; Kramer, Gero ; Seitz, Christian ; Haitel, Andrea ; Baltzer, Pascal ; Hacker, Marcus ; Wadsak, Wolfgang ; Pfaff, Sarah ; Wiatr, Tomasz ; Mitterhauser, Markus ; Shariat, Shahrokh F. ; Hartenbach, Markus

European journal of nuclear medicine and molecular imaging, 2019-09, Vol.46 (10), p.2169-2177 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
Prospective evaluation of the performance of [68Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy
Autor: Abufaraj, Mohammad ; Grubmüller, Bernhard ; Zeitlinger, Markus ; Kramer, Gero ; Seitz, Christian ; Haitel, Andrea ; Baltzer, Pascal ; Hacker, Marcus ; Wadsak, Wolfgang ; Pfaff, Sarah ; Wiatr, Tomasz ; Mitterhauser, Markus ; Shariat, Shahrokh F. ; Hartenbach, Markus
Assuntos: Accuracy ; Aged ; Biopsy ; Cancer surgery ; Cardiology ; Deprivation ; Diagnostic systems ; Dissection ; Edetic Acid - analogs & derivatives ; Gallium Isotopes ; Gallium Radioisotopes ; Histopathology ; Humans ; Imaging ; Lymph nodes ; Lymphatic Metastasis - diagnostic imaging ; Lymphatic Metastasis - pathology ; Lymphatic system ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging - standards ; Male ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Middle Aged ; Multimodal Imaging - methods ; Multimodal Imaging - standards ; Nuclear Medicine ; Oligopeptides ; Oncology ; Oncology – Genitourinary ; Original ; Original Article ; Orthopedics ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography - methods ; Positron Emission Tomography Computed Tomography - standards ; Predictive Value of Tests ; Prostate cancer ; Prostatectomy ; Prostatectomy - methods ; Prostatic Neoplasms - diagnostic imaging ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Radiation therapy ; Radiology ; Radiopharmaceuticals ; Regional analysis ; Regional planning ; Salvage ; Sensitivity analysis ; Tomography ; Urological surgery
É parte de: European journal of nuclear medicine and molecular imaging, 2019-09, Vol.46 (10), p.2169-2177
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Purpose To assess the accuracy of [ 68 Ga]-PSMA-11 PET/CT or [ 68 Ga]-PSMA-11 PET/MRI (PSMA-11 PET/CT(MRI)) for lymph node (LN) staging using salvage LN dissection (SLND) in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). Patients and methods In a prospective study, 65 consecutive patients who developed BCR after RP underwent SLND after PSMA-11 PET/CT(MRI) between 2014 and 2018. Extended SLND up to the inferior mesenteric artery was performed in all patients. Regional and template-based correlations between the presence of LN metastases on histopathology and whole-body PSMA-11 PET/CT(MRI) results were evaluated. The diagnostic accuracy of PSMA-11 PET/CT(MRI) was also evaluated in relation to PSA level at the time of SLND. Results The median age of the patients at the time of SLND was 65 years (IQR 63–69 years) and the median PSA level was 1.4 ng/ml (IQR 0.8–2.9 ng/ml). Before SLND, 50 patients (77%) had additional therapy after RP (26.2% androgen-deprivation therapy and 50.8% radiotherapy). The median number of LNs removed on SLND was 40 (IQR 33–48) and the median number of positive nodes was 4 (IQR 2–6). LN metastases were seen in 13.8% of resected LNs (317 of 2,292). LNs positive on PSMA-11 PET/CT(MRI) had a median diameter of 7.2 mm (IQR 5.3–9 mm). Metastatic LNs in regions negative on PSMA-11 PET had a median diameter of 3.4 mm (IQR 2.1–5.4 mm). In a regional analysis, the sensitivity of PSMA-11 PET/CT(MRI) ranged from 72% to 100%, and the specificity from 96% to 100%. Region-specific positive and negative predictive values ranged from 95% to 100% and 93% to 100%, respectively. Conclusion PSMA-11 PET/CT(MRI) has a very good performance for the identification of LN metastases in patients with BCR after RP. The high diagnostic accuracy in the regional and subregional analyses demonstrates the potential of this approach to enable a region-directed instead of a complete bilateral therapeutic intervention. The performance of PSMA-11 PET/CT(MRI) is dependent on the PSA level and the size of the metastatic deposit.
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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Prospective evaluation of the performance of [68Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy

Abufaraj, Mohammad ; Grubmüller, Bernhard ; Zeitlinger, Markus ; Kramer, Gero ; Seitz, Christian ; Haitel, Andrea ; Baltzer, Pascal ; Hacker, Marcus ; Wadsak, Wolfgang ; Pfaff, Sarah ; Wiatr, Tomasz ; Mitterhauser, Markus ; Shariat, Shahrokh F. ; Hartenbach, Markus

Berlin/Heidelberg: Springer Berlin Heidelberg

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