Department of Urology, Acibadem Taksim Hospital, Inonu Mah., Nizamiye Cad. No:1, 34373 Sisli, Istanbul, Turkey.
Department of Nuclear Medicine, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1806-1812. doi: 10.1007/s00259-017-3752-y. Epub 2017 Jun 18.
To assess the diagnostic accuracy of Ga-PSMA PET in predicting lymph node (LN) metastases in primary N staging in high-risk and very high-risk nonmetastatic prostate cancer in comparison with morphological imaging.
This was a multicentre trial of the Society of Urologic Oncology in Turkey in conjunction with the Nuclear Medicine Department of Cerrahpasa School of Medicine, Istanbul University. Patients were accrued from eight centres. Patients with high-risk and very high-risk disease scheduled to undergo surgical treatment with extended LN dissection between July 2014 and October 2015 were included. Either MRI or CT was used for morphological imaging. PSMA PET/CT was performed and evaluated at a single centre. Sensitivity, specificity and accuracy were calculated for the detection of lymphatic metastases by PSMA PET/CT and morphological imaging. Kappa values were calculated to evaluate the correlation between the numbers of LN metastases detected by PSMA PET/CT and by histopathology.
Data on 51 eligible patients are presented. The sensitivity, specificity and accuracy of PSMA PET in detecting LN metastases in the primary setting were 53%, 86% and 76%, and increased to 67%, 88% and 81% in the subgroup with of patients with ≥15 LN removed. Kappa values for the correlation between imaging and pathology were 0.41 for PSMA PET and 0.18 for morphological imaging.
PSMA PET/CT is superior to morphological imaging for the detection of metastatic LNs in patients with primary prostate cancer. Surgical dissection remains the gold standard for precise lymphatic staging.
与形态影像学相比，评估 Ga-PSMA PET 在预测高危和极高危非转移性前列腺癌原发 N 分期中淋巴结（LN）转移的诊断准确性。
这是土耳其泌尿肿瘤学会与伊斯坦布尔大学 Cerrahpasa 医学院核医学系合作进行的一项多中心试验。从 8 个中心招募患者。纳入计划接受扩大 LN 解剖手术治疗的高危和极高危疾病患者。使用 MRI 或 CT 进行形态影像学检查。PSMA PET/CT 在一个中心进行并进行评估。计算 PSMA PET/CT 和形态影像学检测淋巴转移的敏感性、特异性和准确性。计算 Kappa 值以评估 PSMA PET/CT 和组织病理学检测到的 LN 转移数量之间的相关性。
报告了 51 名符合条件患者的数据。PSMA PET 在原发性疾病中检测 LN 转移的敏感性、特异性和准确性分别为 53%、86%和 76%，在去除≥15 个 LN 的亚组中分别增加到 67%、88%和 81%。PSMA PET 与影像学之间的相关性的 Kappa 值为 0.41，形态影像学为 0.18。
PSMA PET/CT 比形态影像学更能检测原发性前列腺癌患者的转移性 LN。手术解剖仍然是精确淋巴分期的金标准。
