Pfister, David, Porres, Daniel, Heidenreich, Axel, Heidegger, Isabel, Knuechel, Ruth, Steib, Florian, Behrendt, Florian F. and Verburg, Frederik A. (2016). Detection of recurrent prostate cancer lesions before salvage lymphadenectomy is more accurate with Ga-68-PSMA-HBED-CC than with F-18-Fluoroethylcholine PET/CT. Eur. J. Nucl. Med. Mol. Imaging, 43 (8). S. 1410 - 1418. NEW YORK: SPRINGER. ISSN 1619-7089

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Abstract

Aim [Ga-68]PSMA-HBED-CC (Ga-68-PSMA) is a novel and promising tracer for highly sensitive combined integrated positron emission tomography and X-ray computed tomography (PET/CT) diagnosis of recurrent prostate cancer (PCA). Our aim was to assess the sensitivity, specificity, positive and negative predictive value (PPV/NPV), and accuracy per lesion, as well as the positive predictive value per patient of Ga-68-PSMA PET/CT using post-lymphadenectomy histology as a standard, and to compare these values to those obtained in a patient collective scanned using F-18-Fluoroethylcholine ((FEC)-F-18) PET/CT. Methods Thirty eight patients had (FEC)-F-18 and 28 patients had Ga-68-PSMA. We performed a pelvic and/or retroperitoneal lymphadenectomy, if necessary supplemented by resection of locally recurrent lesions in accordance with imaging results. Results In 30/38 (FEC)-F-18 and 23/28 Ga-68-PSMA patients a parts per thousand yen1 focus of PCA was identified in postsurgical histology, leading to a per-patient PPV of 78.9 % for (FEC)-F-18 and 82.1 % for Ga-68-PSMA. In (FEC)-F-18 and Ga-68-PSMA patients, a total of 378 and 308 lymph nodes and local lesions were removed, respectively. For (FEC)-F-18 and (68)for Ga-PSMA, the respective sensitivity (95 % confidence interval) was 71.2 % (64.5-79.6 %) and 86.9 % (75.8-94.2 %), specificity was 86.9 % (82.3-90.6 % ) and 93.1 % (89.2-95.9 %), PPV was 67.3 % (57.7-75.9 %) and 75.7 % (64.0-98.5 %), NPV was 88.8 % (84.4-92.3 %) and 96.6 % (93.5-98.5 %), and accuracy was 82.5 % (78.3-86.8 %) and 91.9 % (88.7 %-95.1 %). Conclusion In the present series Ga-PSMA PET/CT shows a better performance than FEC PET/CT with a significantly higher NPV and accuracy for the detection of locoregional recurrent and/or metastatic lesions prior to salvage lymphadenectomy.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Pfister, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Porres, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidenreich, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidegger, IsabelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knuechel, RuthUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steib, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Behrendt, Florian F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verburg, Frederik A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-271225
DOI: 10.1007/s00259-016-3366-9
Journal or Publication Title: Eur. J. Nucl. Med. Mol. Imaging
Volume: 43
Number: 8
Page Range: S. 1410 - 1418
Date: 2016
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1619-7089
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
GA-68-LABELED PSMA LIGAND; LYMPH-NODE DISSECTION; BIOCHEMICAL RECURRENCE; F-18-CHOLINE PET/CT; DIAGNOSIS; METASTASIS; THERAPY; FAILUREMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27122

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