68-Ga-PSMA-PET in the diagnosis of local recurrent disease after radiotherapy in patients with prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 213-213
Author(s):  
David Pfister ◽  
Matthias Schmidt ◽  
Tobias Kohl ◽  
Daniel Porres-Knoblauch ◽  
Axel Heidenreich
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Predictive Value ◽  
Preoperative Staging ◽  
Cancer Recurrence ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Extended Lymph Node Dissection ◽  
Psma Pet ◽  
Sensitivity Specificity

213 Background: For planning salvage procedures in recurrent prostate cancer accurate diagnostic tools are needed. Till now in patients suspicious for isolated local recurrent cancer invasive biopsy was needed. 68-Ga-PSMA-PET is frequently used to identify even small metastatic deposits. We analyzed the diagnostic value to identify local recurrence in patients after radiotherapy undergoing salvage radical prostatectomy, sRPE. Methods: We retrospectively reviewed patients undergoing sRPE with 68-Ga-PSMA-PET as preoperative staging. All patients underwent sRPE and extended lymph node dissection. Sensitivity, Specificity, pos and neg predictive value had been calculated per patient and per prostate lobe. Results: 37 patients with preoperative 68-Ga-PSMA-PEt could be identified. In all but one at least in one lobe PSMA staining could be identified. Mean tumor volume per prostate lobe was 6.22 (0.1-24)ml. Sensitivity, Specificity, neg and pos predictive value per lobe is 80%, 75%, 32% and 96%. Sensitivity to identify cancer recurrence per person irrespective of the side is 95% with a pos predictive value of 100%. Conclusions: 68-Ga-PSMA-PET seems to have a very high diagnistic value to identify local recurrence after radiotherapy. After validation of our experience an invasive biopsy to proof cancer recurrence might be spared.

Prediction of postoperative histology in patients with prostate cancer using preoperative Ga-68-PSMA-PET/CT.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 144-144
Author(s):  
Martin Boegemann ◽  
Axel Semjonow ◽  
Hans-Joerg Breyholz ◽  
Andres Jan Schrader ◽  
Laura-Maria Krabbe ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Standard Uptake Value ◽  
Whole Body ◽  
Diagnostic Tools ◽  
Likelihood Ratios ◽  
Psma Pet ◽  
Pet Ct ◽  
Detect Prostate Cancer ◽  
Sensitivity Specificity ◽  
Specific Membrane

144 Background: Recently developed 68Ga labeled prostate specific membrane antigen (PSMA) ligands were introduced as diagnostic tools to detect prostate cancer (PCa), PCa relapse and metastases with high accuracy. In this study we assessed the usability of preoperative PSMA-PET/CT information on congruency of spread of PCA compared with postoperative PCa-maps derived from radical prostatectomy (RPE) specimens. Methods: We referred 6 patients with biopsy proven high risk PCa to PSMA-PET/CT prior to RPE. Whole body PET/CT (Biograph mCT with 128 slice CT, Siemens) was performed 62±8 minutes after injection of 160±31 MBq [68Ga]-PSMA-HBED-CC (DKFZ-Ga-PSMA-11) as described by routine acquisition protocol. After RPE, prostate specimens were processed in the local pathology department. Topographical analysis of extension of PCa was reconstructed from representative slides on a schematic diagram resulting in a PCa-map of the prostate. After aligning the cutting planes of the PSMA-PET/CT to the PCa-map we defined 20 segments of the prostate and the seminal vesicles. We measured the maximum standard uptake value (SUV) of PSMA activity of the respective segments and compared the concordance of PSMA-positive and -negative areas with those of PCa and no PCa on the PCa-maps. We calculated sensitivity, specificity, positive and negative likelihood ratios (LR) taking available segments into account. Results: 106/112 segments were analyzed. 8 segments were excluded due to spillover of PSMA-activity in bladder urine. All but 3 segments with no PCa on the PCa-maps showed no uptake in PSMA-PET/CT (Specificity = 92%). The sensitivity of PSMA-PET/CT for showing PCa areas was equally 92%. The positive and negative LR for PSMA-PET/CT detecting or ruling out PCa was 11.5 and 0.09, respectively. Conclusions: This preliminary proof of concept study shows that prediction of later pathologic results in RPE-specimens could be estimated by preoperative PSMA-PET/CT. With optimized acquisition protocols it may be possible to improve our preliminary results. Perspectively PSMA-PET/CT may be helpful for identifying PCa suspicious lesions prior to prostate biopsy and support decision making prior to RPE or radiation therapy.

Clinical accuracy of detecting recurrent prostate cancer lesions with F-18-Fluoroethylcholine or Ga-68-PSMA-HBED-CC PET/CT.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 218-218
Author(s):  
David J. K. P. Pfister ◽  
Daniel Porres ◽  
Axel Heidenreich ◽  
Florian Behrendt ◽  
Frederik Verburg
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Recurrent Prostate Cancer ◽  
Retroperitoneal Lymphadenectomy ◽  
Imaging Results ◽  
Psma Pet ◽  
Pet Ct ◽  
Study Results ◽  
Clinical Accuracy ◽  
Sensitivity Specificity

218 Background: Ga-68-PSMA-HBED-CC (PSMA) is a novel and promising tracer for highly sensitive PET/CT diagnosis in recurrent prostate cancer (PCA). The aim of the present work was to assess the sensitivity, specificity, positive and negative predictive value (PPV/NPV) per lesion as well as the positive predictive value per patient of PSMA PET/CT in patients with recurrent prostate cancer referred for surgery after a positive PET/CT and to compare this with a collective of patients scanned using the current de-facto PET/CT standard tracer F-18-Fluoroethylcholine (FEC). Methods: In this retrospective study results of PET/CTs and post-surgical histological analysis were compared. 38 patients had FEC and 27 patients had PSMA. We performed a pelvic and/or retroperitoneal lymphadenectomy, if necessary supplemented by resection of locally recurrent lesions in accordance with imaging results. Results: In 30/38 FEC and 22/27 PSMA patients at least one focus of PCA was identified in postsurgical histology, leading to a PPV of 78.9% for FEC and 81.5% for PSMA. In FEC and PSMA patients a total of 378 and 308 lymph nodes and local lesions were removed, respectively. For FEC and PSMA the respective sensitivity was 71.2% and 86.9%, specificity 86.9% and 93.1%, PPV 67.3% and 75.7% and NPV 88.8% and 96.6%. Conclusions: In the present series PSMA PET/CT shows a somewhat better performance than the current de-facto PET/CT standard tracer FEC. Due to the very high NPV of PSMA PET/CT a selective locoregional lymphadenectomy involving only the regions affected on imaging can be discussed.

scholarly journals Detection of prostate cancer with 18F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial

2020 ◽  
Author(s):  
Y. J. L. Bodar ◽  
B. H. E. Jansen ◽  
J. P. van der Voorn ◽  
G. J. C. Zwezerijnen ◽  
D. Meijer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Prostate Gland ◽  
Targeted Biopsy ◽  
Psma Pet ◽  
Pet Ct ◽  
Sensitivity Specificity

Abstract Purpose In primary prostate cancer (PCa) patients, accurate staging and histologic grading are crucial to guide treatment decisions. 18F-DCFPyL (PSMA)-PET/CT has been successfully introduced for (re)staging PCa, showing high accuracy to localise PCa in lymph nodes and/or osseous structures. The diagnostic performance of 18F-DCFPyL-PET/CT in localizing primary PCa within the prostate gland was assessed, allowing for PSMA-guided targeted-prostate biopsy. Methods Thirty patients with intermediate-/high-risk primary PCa were prospectively enrolled between May 2018 and May 2019 and underwent 18F-DCFPyL-PET/CT prior to robot-assisted radical prostatectomy (RARP). Two experienced and blinded nuclear medicine physicians assessed tumour localisation within the prostate gland on PET/CT, using a 12-segment mapping model of the prostate. The same model was used by a uro-pathologist for the RARP specimens. Based on PET/CT imaging, a potential biopsy recommendation was given per patient, based on the size and PET-intensity of the suspected PCa localisations. The biopsy recommendation was correlated to final histopathology in the RARP specimen. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for clinically significant PCa (csPCa, Gleason score ≥ 3 + 4 = 7) were assessed. Results The segments recommended for potential targeted biopsy harboured csPCA in 28/30 patients (93%), and covered the highest Gleason score PCa segment in 26/30 patient (87%). Overall, 122 of 420 segments (29.0%) contained csPCa at final histopathological examination. Sensitivity, specificity, PPV and NPV for csPCa per segment using 18F-DCFPyL-PET/CT were 61.4%, 88.3%, 68.1% and 84.8%, respectively. Conclusions When comparing the PCa-localisation on 18F-DCFPyL-PET/CT with the RARP specimens, an accurate per-patient detection (93%) and localisation of csPCa was found. Thus, 18F-DCFPyL-PET/CT potentially allows for accurate PSMA-targeted biopsy.

scholarly journals Diagnostic Value of Dystrophin Immunostaining in the Diagnosis of Duchenne and Becker Muscular Dystrophy Patients

2021 ◽  
Vol 9 (A) ◽  
pp. 1137-1141
Author(s):  
Shinta Andi Sarasati ◽  
Kristy Iskandar ◽  
Maria Alethea Septianastiti ◽  
Rusdy Ghazali Malueka ◽  
Ery Kus Dwianingsih
Keyword(s):  
Genetic Testing ◽  
Muscular Dystrophy ◽  
Muscle Biopsy ◽  
Predictive Value ◽  
False Negative ◽  
High Sensitivity ◽  
Becker Muscular Dystrophy ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Sensitivity Specificity

Background: Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are X-linked recessive muscular disorders caused by the absence or reduction of the muscle cytoskeletal protein dystrophin. Standard procedures to detect deletion and duplication of the DMD gene use Multiplex Ligation-Dependent Probe Amplification (MLPA). However, genetic testing, such as MLPA, is not covered by the national insurance scheme in Indonesia. Immunohistochemical (IHC) staining of dystrophin from muscle biopsy in the form of Formalin-Fixed Paraffin-Embedded (FFPE) specimens can be an alternative method to detect dystrophin expression in protein levels to establish the diagnosis of DMD or BMD. Objectives: To determinate sensitivity, specificity and accuracy of IHC analysis of dystrophin in DMD/BMD patient in comparison with the standard genetic testing, MLPA. Methods: Twenty-six patients enrolled in this study were clinically diagnosed as DMD/BMD in Dr. Sardjito Hospital and Universitas Gadjah Mada Academic Hospital. Genomic DNA was isolated from 3 mL of EDTA-peripheral whole blood samples. The deletion and duplication of DMD genes were detected by MLPA. IHC examination was performed using a specific antibody dystrophin (DYS2). Complete loss of dystrophin staining indicated DMD, while partial loss of dystrophin staining indicated BMD. MLPA result was used as the gold standard to determine sensitivity, specificity, and accuracy of IHC technique using a 2x2 table. Results: MLPA results revealed 18 (18/26; 69.3%) patients with deletion and 3 (3/26; 11.5%) patients with duplication. Five (5/26; 19.2%) patients who showed no deletion nor duplication were excluded from the analysis. Among 21 patients with deletion or duplication, 18 (18/21; 85.7%) patients were out-of-frame (DMD) and 3 (3/21; 14.3%) patients were in-frame (BMD). Six patients showed a discrepancy between the IHC and MLPA results with 9.5% (2/21) false positive and 19% (4/21) false negative. The sensitivity of dystrophin IHC was 77.78%, specificity 33.33%, positive predictive value 87.5%, negative predictive value 20%, and accuracy 71.43%. Conclusion: Muscle biopsy followed by IHC can be one of the diagnostic tools to diagnose BMD or DMD, with high sensitivity. The protein-based strategy is probably the most efficient way to approach the diagnosis of Duchenne and Becker muscular dystrophy in limited health care settings.

Krebstherapie – 68Ga-PSMA-PET/CT beim rezidivierten Prostatakarzinom richtungweisend und kosteneffektiv

2020 ◽  
Vol 25 (04) ◽  
pp. 184-185
Author(s):  
Susanne Krome
Keyword(s):  
Prostate Cancer ◽  
Cancer Recurrence ◽  
Intention To Treat ◽  
Biochemisches Rezidiv ◽  
Choline Pet ◽  
Psma Pet ◽  
Pet Ct ◽  
Prostate Cancer Recurrence ◽  
Treat Analysis

Schwenck J et al. Intention-to-Treat Analysis of 68Ga-PSMA and 11C-Choline PET/CT Versus CT for Prostate Cancer Recurrence After Surgery. J Nucl Med 2019; 60: 1359–1365 15–40 % der Patienten mit einem Prostatakarzinom erleiden postoperativ ein biochemisches Rezidiv. In der retrospektiven Analyse beeinflussten die Bildgebungsverfahren die Häufigkeit einer richtigen Therapiewahl. Die Autoren empfehlen die 68Ga-PSMA-PET/CT, die die höchste Genauigkeit aufwies. Unter Berücksichtigung der Kosten für inadäquate Behandlungen entstünden keine ökonomischen Nachteile.

scholarly journals New screening approach to detecting congenital syphilis in China: a retrospective cohort study

2020 ◽  
pp. archdischild-2020-320549
Author(s):  
Fang Hu ◽  
Shuai-Jun Guo ◽  
Jian-Jun Lu ◽  
Ning-Xuan Hua ◽  
Yan-Yan Song ◽  
...  
Keyword(s):  
Predictive Value ◽  
Congenital Syphilis ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Operating Characteristics ◽  
Loss To Follow Up ◽  
Sensitivity Specificity ◽  
Mother To Child ◽  
Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

scholarly journals Endoscopic-Ultrasound-Guided Tissue Sampling Facilitates the Detection of Local Recurrence and Extra Pelvic Metastasis in Pelvic Urologic Malignancy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ferga C. Gleeson ◽  
Jonathan E. Clain ◽  
R. Jeffrey Karnes ◽  
Elizabeth Rajan ◽  
Mark D. Topazian ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Local Recurrence ◽  
Endoscopic Ultrasound ◽  
Gold Standard ◽  
Final Diagnosis ◽  
Tissue Sampling ◽  
Invasive Method ◽  
Urologic Malignancy ◽  
Sensitivity Specificity

Pelvic lymph node dissection is the gold standard for assessing nodal disease in prostate or bladder cancer and is superior to CT, MRI and PET staging. Endoscopic ultrasound (EUS) provides an alternative, less invasive method of cytohistologic material acquisition, but its performance in pelvic urologic malignancy is unknown. Therefore, our aim was to evaluate the diagnostic accuracy of EUS guided tissue sampling for these malignancies when compared to a composite cytohistologic and surgical gold standard. A median of 3 FNA passes were performed (n=19 patients) revealing a sensitivity, specificity, PPV and NPV of 94.4% (72–99), 100% (2–100), 100% (80–100) and 50% (1–98) respectively. The perirectal space was the most frequently sampled location irrespective of the primary urological cancer origin. Final diagnosis established by EUS tissue sampling included bladder cancer (n=1), bladder cancer local recurrence (n=8), bladder cancer extra pelvic metastases (n=1), prostate cancer (n=2), prostate cancer local recurrence (n=4), prostate cancer extra pelvic metastases (n=1), testicular cancer extra pelvic metastases (n=1) and a benign seminal vesicle (n=1). EUS guided sampling of the gut wall, lymph nodes, or perirectal space yields suitable diagnostic material to establish the presence of primary, local recurrence or extra pelvic metastases of pelvic urologic malignancy.

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

Sign in / Sign up

Export Citation Format

Share Document