Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in 68Ga-PSMA-11-PET of PET/CT and PET/MRI

• Verfasst von: Freitag, Martin T. [VerfasserIn]
• Verfasst von: Radtke, Jan Philipp [VerfasserIn]
• Verfasst von: Afshar-Oromieh, Ali [VerfasserIn]
• Verfasst von: Hadaschik, Boris [VerfasserIn]
• Verfasst von: Wieczorek, Kathrin [VerfasserIn]
• Verfasst von: Flechsig, Paul [VerfasserIn]
• Verfasst von: Giesel, Frederik L. [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Haberkorn, Uwe [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Verfasst von: Dimitrakopoulou-Strauss, A. [VerfasserIn]
• Titel: Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in 68Ga-PSMA-11-PET of PET/CT and PET/MRI
• Titelzusatz: comparison with mpMRI integrated in simultaneous PET/MRI
• Verf.angabe: Martin T. Freitag, Jan P. Radtke, Ali Afshar-Oromieh, Matthias C. Roethke, Boris A. Hadaschik, Martin Gleave, David Bonekamp, Klaus Kopka, Matthias Eder, Thorsten Heusser, Marc Kachelriess, Kathrin Wieczorek, Christos Sachpekidis, Paul Flechsig, Frederik Giesel, Markus Hohenfellner, Uwe Haberkorn, Heinz-Peter Schlemmer, A. Dimitrakopoulou-Strauss
• Jahr: 2017
• Jahr des Originals: 2016
• Umfang: 12 S.
• Teil: volume:44
• Teil: year:2017
• Teil: number:5
• Teil: pages:776-787
• Teil: extent:12
• Fussnoten: First online 17 December 2016 ; Gesehen am 02.05.2018 ; Im Titel ist 68 hochgestellt
• Titel Quelle: Enthalten in: European journal of nuclear medicine and molecular imaging
• Ort Quelle: Heidelberg [u.a.] : Springer-Verl., 2002
• Jahr Quelle: 2017
• Band/Heft Quelle: 44(2017), 5, Seite 776-787
• ISSN Quelle: 1619-7089
• DOI: doi:10.1007/s00259-016-3594-z
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1572506636

Abstract

PurposeThe positron emission tomography (PET) tracer 68Ga-PSMA-11, targeting the prostate-specific membrane antigen (PSMA), is rapidly excreted into the urinary tract. This leads to significant radioactivity in the bladder, which may limit the PET-detection of local recurrence (LR) of prostate cancer (PC) after radical prostatectomy (RP), developing in close proximity to the bladder. Here, we analyze if there is additional value of multi-parametric magnetic resonance imaging (mpMRI) compared to the 68Ga-PSMA-11-PET-component of PET/CT or PET/MRI to detect LR.MethodsOne hundred and nineteen patients with biochemical recurrence after prior RP underwent both hybrid 68Ga-PSMA-11-PET/CTlow-dose (1 h p.i.) and -PET/MRI (2-3 h p.i.) including a mpMRI protocol of the prostatic bed. The comparison of both methods was restricted to the abdomen with focus on LR (McNemar). Bladder-LR distance and recurrence size were measured in axial T2w-TSE. A logistic regression was performed to determine the influence of these variables on detectability in 68Ga-PSMA-11-PET. Standardized-uptake-value (SUVmean) quantification of LR was performed.ResultsThere were 93/119 patients that had at least one pathologic finding. In addition, 18/119 Patients (15.1%) were diagnosed with a LR in mpMRI of PET/MRI but only nine were PET-positive in PET/CT and PET/MRI. This mismatch was statistically significant (p = 0.004). Detection of LR using the PET-component was significantly influenced by proximity to the bladder (p = 0.028). The PET-pattern of LR-uptake was classified into three types (1): separated from bladder; (2): fuses with bladder, and (3): obliterated by bladder). The size of LRs did not affect PET-detectability (p = 0.84), mean size was 1.7 ± 0.69 cm long axis, 1.2 ± 0.46 cm short-axis. SUVmean in nine men was 8.7 ± 3.7 (PET/CT) and 7.0 ± 4.2 (PET/MRI) but could not be quantified in the remaining nine cases (obliterated by bladder).ConclusionThe present study demonstrates additional value of hybrid 68Ga-PSMA-11-PET/MRI by gaining complementary diagnostic information compared to the 68Ga-PSMA-11-PET/CTlow-dose for patients with LR of PC.