Martinez Juana, Subramanian Kritika, Margolis Daniel, O'Dwyer Elisabeth, Osborne Joseph, Jhanwar Yuliya, Nagar Himanshu, Williams Nicholas, RoyChoudhury Arindam, Madera Gabriela, Babich John, Huicochea Castellanos Sandra
Division of Molecular Imaging and Therapeutics, Department of Radiology, Weill Cornell Medicine, 525 E 68th Street, New York, NY 10065, USA.
Division of Molecular Imaging and Therapeutics, Department of Radiology, Weill Cornell Medicine, 525 E 68th Street, New York, NY 10065, USA.
Transl Oncol. 2022 Jan;15(1):101242. doi: 10.1016/j.tranon.2021.101242. Epub 2021 Oct 11.
The primary objective was to compare the overall diagnostic performance, presented as detection rate of Ga-PSMA-HBED-CC positron emission tomography/magnetic resonance imaging (PSMA PET/MRI) versus conventional, multiparametric MRI (mpMRI) in a population of patients with biochemically recurrent prostate cancer. In conjunction with this analysis, secondary objectives included the evaluation of the detection rate stratified by PSA levels and primary treatment modality.
A total of 165 PSMA PET MRI were performed from April 2018 to May 2021, of whom 108 were presenting for biochemical recurrent disease. The PSMA PET vertex to thigh were read by two different board-certified nuclear medicine physicians while the MRI head and neck, chest, abdomen, and pelvis (with dedicated, PI-RADS compliant multiparametric prostate MRI) were read by two board certified diagnostic radiologists.
PSMA PET/MRI had a higher detection rate than mpMRI when evaluating patients with biochemical recurrence (BCR) with similar results demonstrated when sub-analysis was performed using PSA levels, primary treatment modality, and time since androgen deprivation therapy. Our study also showed PSMA PET/MRI had a higher sensitivity than mpMRI.
Our findings demonstrate that PSMA PET/MRI is a better imaging modality in the detection of disease in the setting of BCR when compared to MRI alone. Combined utility with PSMA PET/MRI is a powerful tool which can aid in not only the detection of disease, but also guide in treatment planning for prostate cancer patients.
主要目的是比较镓-PSMA-HBED-CC正电子发射断层扫描/磁共振成像（PSMA PET/MRI）与传统多参数MRI（mpMRI）在生化复发前列腺癌患者群体中的总体诊断性能。在此分析的同时，次要目标包括评估按PSA水平和初始治疗方式分层的检出率。
2018年4月至2021年5月共进行了165例PSMA PET MRI检查，其中108例为生化复发疾病。PSMA PET从头顶至大腿由两名不同的获得委员会认证的核医学医师阅片，而MRI的头颈部、胸部、腹部和骨盆（采用符合PI-RADS标准的专用多参数前列腺MRI）由两名获得委员会认证的诊断放射科医师阅片。
在评估生化复发（BCR）患者时，PSMA PET/MRI的检出率高于mpMRI，在使用PSA水平、初始治疗方式以及雄激素剥夺治疗后的时间进行亚分析时也得到了类似结果。我们的研究还表明，PSMA PET/MRI的敏感性高于mpMRI。
我们的研究结果表明，与单独的MRI相比，PSMA PET/MRI在检测BCR情况下的疾病方面是一种更好的成像方式。PSMA PET/MRI的联合应用是一种强大的工具，不仅有助于疾病的检测，还能指导前列腺癌患者的治疗规划。
