Nuclear Medicine, UZ Leuven, Herestraat, 49 3000, Leuven, Belgium.
Radiology, UZ Leuven, Leuven, Belgium.
Eur Radiol. 2022 Feb;32(2):901-911. doi: 10.1007/s00330-021-08140-0. Epub 2021 Aug 10.
PSMA-PET has become the PET technique of choice to localise the site of biochemically recurrent prostate cancer (PCa). With hybrid PET/MRI, the advantages of MRI are added to molecular characteristic of PET. The aim of this study was to investigate the incremental value of PET/MR versus PET/CT in patients with biochemically recurrent PCa by head-to-head comparison.
Thirty-four patients with biochemically recurrent PCa were prospectively included. They underwent [Ga]Ga-PSMA-11 PET/CT, followed by simultaneous PET/MR. All PET (PET, PET), CT and MR images were evaluated for number of lesions and location. The number of lesions at specific sites was compared using Wilcoxon-sign-rank test. For PET, the maximum and mean standardised uptake values (SUVs) were calculated for each lesion compared using a two-sided paired t test.
PET and PET scans were positive in 19 and 20 patients, detecting 73 and 79 lesions respectively. All lesions detected on PET were also detected on PET. CT and MRI only were positive in 14 and 17 patients, detecting 38 and 50 lesions, respectively, which was significantly lower than PET and PET respectively. Combined interpretation showed more lesions on PET/MR than on PET/CT (88 vs 81). No significant difference in detection of presence of local recurrence nor distant metastases was found. SUV and SUV values were significantly higher on PET than on PET in local recurrence and lymph node metastases.
[Ga]Ga-PSMA-11 PET/MR was able to detect biochemically recurrent PCa at least as accurately as PET/CT for local recurrence, lymph node metastasis and distant metastasis.
• PSMA PET/MRI detects the location of biochemical recurrence at least as accurately as PET/CT. • Substitution of PET/CT by PET/MRI adds sensitivity in PSMA lesion detection also in the setting of distant recurrence due to both the MR and TOF PET components.
PSMA-PET 已成为定位生化复发前列腺癌（PCa）的首选 PET 技术。通过杂交 PET/MRI，将 MRI 的优势与 PET 的分子特征相结合。本研究旨在通过头对头比较，探讨 PSMA-PET/MRI 相对于 PSMA-PET/CT 在生化复发 PCa 患者中的附加价值。
前瞻性纳入 34 例生化复发 PCa 患者。他们接受了 [Ga]Ga-PSMA-11 PET/CT 检查，随后进行了同时的 PET/MR 检查。所有 PET（PET、PET）、CT 和 MR 图像均用于评估病变数量和位置。使用 Wilcoxon 符号秩检验比较特定部位的病变数量。对于 PET，使用双侧配对 t 检验比较每个病变的最大和平均标准化摄取值（SUV）。
PET 和 PET 扫描分别在 19 例和 20 例患者中呈阳性，分别检测到 73 个和 79 个病变。PET 检测到的所有病变也在 PET 上检测到。CT 和 MRI 仅在 14 例和 17 例患者中呈阳性，分别检测到 38 个和 50 个病变，明显低于 PET 和 PET。综合解读显示，PET/MR 比 PET/CT 检测到更多的病变（88 比 81）。在局部复发和远处转移的检测中，未发现存在局部复发或远处转移的差异。在局部复发和淋巴结转移中，SUV 和 SUV 值在 PET 上明显高于 PET。
[Ga]Ga-PSMA-11 PET/MR 能够与 PET/CT 一样准确地检测生化复发 PCa 患者的局部复发、淋巴结转移和远处转移。
• PSMA PET/MRI 检测生化复发的位置至少与 PET/CT 一样准确。• 由于 MRI 和 TOF PET 成分，PSMA-PET/CT 被 PSMA-PET/MRI 替代可提高病变检测的灵敏度，在远处复发的情况下也是如此。
