The Impact of PSMA PET/CT Imaging in Prostate Cancer Radiation Treatment

Objectives: To investigate the impact of total variation regularized expectation maximization (TVREM) reconstruction on the image quality of 68Ga-PSMA-11 PET/CT using phantom and patient data. Methods: Images of a phantom with small hot sphere inserts and 20 prostate cancer patients were acquired with a digital PET/CT using list-mode and reconstructed with ordered subset expectation maximization (OSEM) and TVREM with seven penalisation factors between 0.01 and 0.42 for 2 and 3 minutes-per-bed (m/b) acquisition. The contrast recovery (CR) and background variability (BV) of the phantom, image noise of the liver, and SUVmax of the lesions were measured. Qualitative image quality was scored by two radiologists using a 5-point scale (1-poor, 5-excellent). Results: The performance of CR, BV, and image noise, and the gain of SUVmax was higher for TVREM 2 m/b groups with the penalization of 0.07 to 0.28 compared to OSEM 3 m/b group (all p < 0.05). The image noise of OSEM 3 m/b group was equivalent to TVREM 2 and 3 m/b groups with a penalization of 0.14 and 0.07, while lesions’ SUVmax increased 15 and 20%. The highest qualitative score was attained at the penalization of 0.21 (3.30 ± 0.66) for TVREM 2 m/b groups and the penalization 0.14 (3.80 ± 0.41) for 3 m/b group that equal to or greater than OSEM 3 m/b group (2.90 ± 0.45, p = 0.2 and p < 0.001). Conclusions: TVREM improves lesion contrast and reduces image noise, which allows shorter acquisition with preserved image quality for PSMA PET/CT. Advances in knowledge: TVREM reconstruction with optimized penalization factors can generate higher quality PSMA-PET images for prostate cancer diagnosis.

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The Impact of 68Ga-PSMA PET/CT and PET/MRI on the Management of Prostate Cancer

Urology ◽

10.1016/j.urology.2019.04.004 ◽

2019 ◽

Vol 130 ◽

pp. 1-12 ◽

Cited By ~ 14

Author(s):

Manuela A. Hoffmann ◽

Helmut J. Wieler ◽

Christian Baues ◽

Nicholas J. Kuntz ◽

Ines Richardsen ◽

...

Keyword(s):

Prostate Cancer ◽

Psma Pet ◽

Pet Ct ◽

The Impact

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Evaluation of PSMA PET/CT imaging using a 68Ga-HBED-CC ligand in patients with prostate cancer and the value of early pelvic imaging

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000000290 ◽

2015 ◽

Vol 36 (6) ◽

pp. 582-587 ◽

Cited By ~ 83

Author(s):

Levent Kabasakal ◽

Emre Demirci ◽

Meltem Ocak ◽

Reşit Akyel ◽

Jamal Nematyazar ◽

...

Keyword(s):

Prostate Cancer ◽

Ct Imaging ◽

Psma Pet ◽

Pet Ct ◽

Pelvic Imaging

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Lymph Node Involvement in Treatment-Naïve Prostate Cancer Patients: Correlation of PSMA PET/CT Imaging and Roach Formula in 280 Men in Radiotherapeutic Management

Journal of Nuclear Medicine ◽

10.2967/jnumed.119.227637 ◽

2019 ◽

Vol 61 (1) ◽

pp. 46-50 ◽

Cited By ~ 6

Author(s):

Stefan A. Koerber ◽

Gerald Stach ◽

Clemens Kratochwil ◽

Matthias F. Haefner ◽

Henrik Rathke ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Involvement ◽

Ct Imaging ◽

Psma Pet ◽

Pet Ct ◽

Treatment Naïve ◽

Node Involvement

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Prior PSMA PET-CT Imaging and Hounsfield Unit Impact on Tumor Yield and Success of Molecular Analyses from Bone Biopsies in Metastatic Prostate Cancer

Cancers ◽

10.3390/cancers12123756 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3756

Author(s):

Minke Smits ◽

Kamer Ekici ◽

Samhita Pamidimarri Naga ◽

Inge M. van Oort ◽

Michiel J. P. Sedelaar ◽

...

Keyword(s):

Prostate Cancer ◽

Molecular Characterization ◽

Metastatic Prostate Cancer ◽

Ct Imaging ◽

Ct Guidance ◽

Prediction Tool ◽

Psma Pet ◽

Pet Ct ◽

Bone Biopsies ◽

Tumor Yield

Developing and optimizing targeted therapies in metastatic castration-resistant prostate cancer (mCRPC) necessitates molecular characterization. Obtaining sufficient tumor material for molecular characterization has been challenging. We aimed to identify clinical and imaging variables of imaging-guided bone biopsies in metastatic prostate cancer patients that associate with tumor yield and success in obtaining molecular results, and to design a predictive model: Clinical and imaging data were collected retrospectively from patients with prostate cancer who underwent a bone biopsy for histological and molecular characterization. Clinical characteristics, imaging modalities and imaging variables, were associated with successful biopsy results. In our study, we included a total of 110 bone biopsies. Histological conformation was possible in 84 of all biopsies, of which, in 73 of the 84, successful molecular characterization was performed. Prior use of PSMA PET-CT resulted in higher success rates in histological and molecular successful biopsies compared to CT or MRI. Evaluation of spine biopsies showed more often successful results compared to other locations for both histological and molecular biopsies (p = 0.027 and p = 0.012, respectively). Low Hounsfield units (HUs) and deviation (Dev), taken at CT-guidance, were associated with histological successful biopsies (p = 0.025 and p = 0.023, respectively) and with molecular successful biopsies (p = 0.010 and p = 0.006, respectively). A prediction tool combining low HUs and low Dev resulted in significantly more successful biopsies, histological and molecular (p = 0.023 and p = 0.007, respectively). Based on these results, we concluded that site selection for metastatic tissue biopsies with prior PSMA PET-CT imaging improves the chance of a successful biopsy. Further optimization can be achieved at CT-guidance, by selection of low HU and low Dev lesions. A prediction tool is provided to increase the success rate of bone biopsies in mCRPC patients, which can easily be implemented in daily practice.

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