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Diagnostic Accuracy of 68 Ga-PSMA-11 PET/MRI Compared with Multiparametric MRI in the Detection of Prostate Cancer.
- Source :
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Radiology [Radiology] 2018 Dec; Vol. 289 (3), pp. 730-737. Date of Electronic Publication: 2018 Sep 18. - Publication Year :
- 2018
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Abstract
- Purpose To compare the diagnostic accuracy of gallium 68 ( <superscript>68</superscript> Ga)-labeled prostate-specific membrane antigen (PSMA)-11 PET/MRI with that of multiparametric MRI in the detection of prostate cancer. Materials and Methods The authors performed a retrospective study of men with biopsy-proven prostate cancer who underwent simultaneous <superscript>68</superscript> Ga-PSMA-11 PET/MRI before radical prostatectomy between December 2015 and June 2017. The reference standard was whole-mount pathologic examination. Readers were blinded to radiologic and pathologic findings. Tumor localization was based on 30 anatomic regions. Region-specific sensitivity and specificity were calculated for PET/MRI and multiparametric MRI by using raw stringent and alternative neighboring approaches. Maximum standardized uptake value (SUV <subscript>max</subscript> ) in the tumor and Prostate Imaging Reporting and Data System (PI-RADS) version 2 grade were compared with tumor Gleason score. Generalized estimating equations were used to estimate population-averaged sensitivity and specificity and to determine the association between tumor characteristics and SUV <subscript>max</subscript> or PI-RADS score. Results Thirty-two men (median age, 68 years; interquartile range: 62-71 years) were imaged. The region-specific sensitivities of PET/MRI and multiparametric MRI were 74% (95% confidence interval [CI]: 70%, 77%) and 50% (95% CI: 45%, 0.54%), respectively, with the alternative neighboring approach (P < .001 for both) and 73% (95% CI: 68%, 79%) and 69% (95% CI: 62%, 75%), respectively, with the population-averaged generalized estimating equation (P = .04). Region-specific specificity of PET/MRI was similar to that of multiparametric MRI with the alternative neighboring approach (88% [95% CI: 85%, 91%] vs 90% [95% CI: 87%, 92%], P = .99) and in population-averaged estimates (70% [95% CI: 64%, 76%] vs 70% [95% CI: 64%, 75%], P = .99). SUV <subscript>max</subscript> was associated with a Gleason score of 7 and higher (odds ratio: 1.71 [95% CI: 1.27, 2.31], P < .001). Conclusion The sensitivity of gallium 68-labeled prostate-specific membrane antigen-11 PET/MRI in the detection of prostate cancer is better than that of multiparametric MRI. © RSNA, 2018 See also the editorial by Civelek in this issue.
- Subjects :
- Aged
Humans
Male
Middle Aged
Prostate diagnostic imaging
Radiopharmaceuticals
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Gallium Radioisotopes
Magnetic Resonance Imaging methods
Positron-Emission Tomography methods
Prostate-Specific Antigen
Prostatic Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1527-1315
- Volume :
- 289
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 30226456
- Full Text :
- https://doi.org/10.1148/radiol.2018180788