Lütje Susanne, Cohnen Joseph, Gomez Benedikt, Grüneisen Johannes, Sawicki Lino, Rübben Herbert, Bockisch Andreas, Umutlu Lale, Pöppel Thorsten D, Wetter Axel
Susanne Lütje, PhD, resident Nuclear Medicine, University Medical Center Essen, Clinic for Nuclear Medicine, Hufelandstraße 55, 45122 Essen, Germany, Tel: +49 201 - 723 83663, E-Mail:
Nuklearmedizin. 2017 Jun 13;56(3):73-81. doi: 10.3413/Nukmed-0850-16-09. Epub 2017 Apr 12.
Evaluate the diagnostic accuracy of Ga-labeled HBED-CC-PSMA-PET/MRI for detection of recurrent PCa in comparison to PET/CT.
48 patients with suspected recurrent PCa underwent PET/CT after injection of the Ga-HBED-CC-PSMA ligand followed by integrated PET/MRI. Image analysis was performed by nuclear medicine physicians and radiologists with respect to the detection of lymph node metastases, bone metastases and local recurrence of the tumour. Image quality was evaluated visually based on a three-point ordinal scale.
From 48 patients initially examined, 25 were finally eligible for qualitative and quantitative image evaluation. In 14 patients, neither PET/CT nor PET/MRI found tumour lesions, and 9 patients were excluded from image analysis due to a pronounced extinction artifact around the urinary bladder (halo). In comparison to Ga-HBED-CC-PSMA-PET/CT, Ga-HBED-CC-PSMA-PET/MRI identified 14 vs. 9 local recurrences in the prostate bed and 23 vs. 20 PET-positive lymph nodes, and 4 vs. 4 PET-positive bone lesions, respectively. While the improved detection of suspicious lymph nodes was primarily attributable to the PET component, the advantageous detection of tumour recurrences in the prostate bed was chiefly referable to the superior soft-tissue contrast of the MR component of integrated PET/MRI. Analysis of SUV revealed that Ga-HBED-CC-PSMA-PET/MRI provided significantly higher SUV compared to Ga-HBED-CC-PSMA-PET/CT (17.6, range 2.0-49.6, and 15.1, range 3.5-36.8, respectively, p = 0.0019).
Ga-HBED-CC-PSMA-PET/MRI was found to be superior as compared to Ga-HBED-CC-PSMA-PET/CT in the detection of PSMA-expressing prostate bed recurrences.
与PET/CT相比，评估镓标记的HBED-CC-PSMA-PET/MRI检测复发性前列腺癌的诊断准确性。
48例疑似复发性前列腺癌患者在注射镓-HBED-CC-PSMA配体后接受PET/CT检查，随后进行PET/MRI融合成像。核医学医师和放射科医生对图像进行分析，以检测淋巴结转移、骨转移和肿瘤局部复发情况。基于三点有序量表对图像质量进行视觉评估。
最初检查的48例患者中，最终有25例符合定性和定量图像评估标准。14例患者PET/CT和PET/MRI均未发现肿瘤病变，9例患者因膀胱周围明显的衰减伪影（晕环）被排除在图像分析之外。与镓-HBED-CC-PSMA-PET/CT相比，镓-HBED-CC-PSMA-PET/MRI分别在前列腺床发现14处与9处局部复发、23处与20处PET阳性淋巴结以及4处与4处PET阳性骨病变。虽然可疑淋巴结检测的改善主要归因于PET部分，但前列腺床肿瘤复发的优势检测主要归因于PET/MRI融合成像中MR部分 superior 的软组织对比度。SUV分析显示，镓-HBED-CC-PSMA-PET/MRI提供的SUV显著高于镓-HBED-CC-PSMA-PET/CT（分别为17.6，范围2.0 - 49.6和15.1，范围3.5 - 36.8，p = 0.0019）。
在检测表达PSMA的前列腺床复发方面，镓-HBED-CC-PSMA-PET/MRI被发现优于镓-HBED-CC-PSMA-PET/CT。
