Head-to-head comparison of 68Ga-prostate-specific membrane antigen PET/CT and ferumoxtran-10 enhanced MRI for the diagnosis of lymph node metastases in prostate cancer patients

Abstract Background: Positron emission tomography-computed tomography (PET-CT) can be used to detect and stage metastatic lymph nodes in intermediate to high-risk prostate cancer. Improvements to hardware, such as digital technology, and to software, such as reconstruction algorithms, have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for [18F]-fluorocholine (FCH). Extended pelvic lymph node dissection (ePLND) histopathology was used as the reference method.Methods: Retrospectively, a consecutive series of patients with prostate cancer who had undergone staging with FCH PET-CT before ePLND were included. Images were obtained with either a conventional or a SiPM-based PET-CT and compared. FCH uptake in pelvic lymph nodes beyond the uptake in the mediastinal blood pool was considered to be abnormal.Results: One hundred eighty patients with intermediate or high-risk prostate cancer were examined using a conventional Philips Gemini PET-CT (n = 93) between 2015 and 2017 or a digital GE Discovery MI PET-CT (n = 87) from 2017 to 2018. Images that were obtained using the Philips Gemini PET-CT system showed 19 patients (20%) with suspected lymph node metastases compared with 40 patients (46%) using the GE Discovery MI PET-CT. Sensitivity, specificity, and positive and negative predictive value (PPV and NPV) were 0.30, 0.84, 0.47, and 0.72, respectively, for the Philips Gemini and 0.60, 0.58, 0.30, and 0.83, respectively for GE Discovery MI. Area under the curve (AUC) in a receiver operating characteristics (ROC) analysis was similar between the two PET-CT systems (0.58 and 0.58, P = 0.8).Conclusions: A marked difference in sensitivity and specificity was found for the different PET-CT systems, although similar overall diagnostic performance. This is probably due to differences in both hard- and software, including reconstruction algorithms, and should be considered when new technology is introduced.

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Additional value of MR/PET fusion compared with PET/CT in the detection of lymph node metastases in cervical cancer patients

European Journal of Cancer ◽

10.1016/j.ejca.2009.04.006 ◽

2009 ◽

Vol 45 (12) ◽

pp. 2103-2109 ◽

Cited By ~ 82

Author(s):

Seok-Ki Kim ◽

Hyuck Jae Choi ◽

Sang-Yoon Park ◽

Ho-Young Lee ◽

Sang-Soo Seo ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Metastases ◽

Pet Ct ◽

Node Metastases ◽

Additional Value

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153 EVALUATION OF CHOLINE PET CT AND DIFFUSION WEIGHTED MRI FOR THE NODAL STAGING OF PROSTATE CANCER WITH A HIGH RISK OF LYMPH NODE METASTASES

European Urology Supplements ◽

10.1016/s1569-9056(10)60157-1 ◽

2010 ◽

Vol 9 (2) ◽

pp. 80

Author(s):

T. Budiharto ◽

S. Joniau ◽

L. Van Den Bergh ◽

E. Lerut ◽

K. Haustermans ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastases ◽

Diffusion Weighted Mri ◽

Nodal Staging ◽

Choline Pet ◽

Pet Ct ◽

Node Metastases ◽

And Diffusion

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242 11C-ACETATE PET/CT IMAGING OF PROSTATE CANCER LYMPH NODE METASTASES AND CORRELATION WITH LYMPHADENECTOMY AND HISTOPATHOLOGY FINDINGS

The Journal of Urology ◽

10.1016/j.juro.2013.02.1622 ◽

2013 ◽

Vol 189 (4S) ◽

Author(s):

Magnus Hellstrom ◽

Martin Schumacher ◽

Eva Radecka ◽

Anders Sundin ◽

Hans Jakobsson

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Ct Imaging ◽

Pet Ct ◽

Node Metastases

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A Phase 2/3 Prospective Multicenter Study of the Diagnostic Accuracy of Prostate-Specific Membrane Antigen PET/CT with 18 F-DCFPyL in Prostate Cancer Patients (OSPREY)

The Journal of Urology ◽

10.1097/ju.0000000000001698 ◽

2021 ◽

Author(s):

Kenneth J. Pienta ◽

Michael A. Gorin ◽

Steven P. Rowe ◽

Peter R. Carroll ◽

Frédéric Pouliot ◽

...

Keyword(s):

Prostate Cancer ◽

Diagnostic Accuracy ◽

Cancer Patients ◽

Multicenter Study ◽

Prostate Specific Membrane Antigen ◽

Phase 2 ◽

Prospective Multicenter Study ◽

Pet Ct ◽

Specific Membrane

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Prostate-specific membrane antigen and fibroblast activation protein distribution in prostate cancer: preliminary data on immunohistochemistry and PET imaging

Annals of Nuclear Medicine ◽

10.1007/s12149-021-01702-8 ◽

2021 ◽

Author(s):

Katharina Kessel ◽

Robert Seifert ◽

Matthias Weckesser ◽

Martin Boegemann ◽

Sebastian Huss ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Pet Imaging ◽

Fibroblast Activation Protein ◽

Prostate Specific Membrane Antigen ◽

Psma Pet ◽

Node Metastases ◽

Small Patient ◽

Specific Membrane ◽

Psma Expression

Abstract Introduction Fibroblast activation protein (FAP) has been recently presented as new imaging target for malignant diseases and offers high contrast to surrounding normal tissue. FAP tracer uptake has been reported in various tumor entities. The aim of this study was to compare FAP and Prostate-specific membrane antigen (PSMA) expression in primary prostate cancer employing histological analyses and PET imaging in two small patient collectives. Methods Two independent small patient collectives were included in this study. For cohort A, data of 5 prostate cancer patients and 3 patients with benign prostate hyperplasia were included. Patients with prostate cancer were initially referred for PSMA PET staging. Radical prostatectomy was performed in all patients and prostate specimen of patients and biopsies of healthy controls were available for further evaluation. Histological workup included HE and immunohistochemistry using PSMA Ab, FAP Ab. Cohort B consists of 6 Patients with diagnosed mCRPC and available PSMA as well as FAP PET. Results Patients with proven prostate cancer infiltration exhibited strong positivity for PSMA in both primary tumors and lymph node metastases while stainings for FAP were found positive in some cases, but not all (2/5). Controls with BPH presented moderate PSMA staining and in one case also with a positive FAP staining (1/3). PET imaging with FAP seemed to result in more precise results in case of low PSMA expression than PSMA-PET. Conclusions While PSMA staining intensity is a valid indicator of prostate cancer in both primary tumor and lymph node metastases, the expression of FAP seems to be heterogeneous but not necessarily linked to cancer-associated fibroblasts. It is also present in inflammation-associated myofibroblasts. Therefore, its ultimate role in prostate cancer diagnosis remains a subject of discussion.

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External evaluation of the Briganti nomogram to predict lymph node metastases in intermediate-risk prostate cancer patients

World Journal of Urology ◽

10.1007/s00345-020-03322-9 ◽

2020 ◽

Author(s):

Nicolas Peilleron ◽

Arnaud Seigneurin ◽

Caroline Herault ◽

Camille Verry ◽

Michel Bolla ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Metastases ◽

Intermediate Risk ◽

External Evaluation ◽

Risk Prostate Cancer ◽

Node Metastases

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Comparison of 11C-choline-PET/CT and whole body-MRI for staging of prostate cancer

Nuklearmedizin ◽

10.1160/nukmed-0075 ◽

2007 ◽

Vol 46 (05) ◽

pp. 161-168 ◽

Cited By ~ 53

Author(s):

A. C. Pfannenberg ◽

A. Rieger ◽

P. Aschoff ◽

M. Müller ◽

F. Paulsen ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Bone Metastases ◽

Lymph Node Metastases ◽

Specific Antigen ◽

Whole Body ◽

Curative Therapy ◽

Pet Ct ◽

Node Metastases ◽

Consensus Reading

SummaryAim of this study was to compare the diagnostic accuracy of positron emission tomography and computed tomography with 11C-Choline (Cho-PET/CT) and whole body magnetic resonance imaging (WB-MRI) for diagnostic work-up of prostate cancer. Patients, methods: We evaluated retrospectively 42 patients with untreated prostate cancer (n = 17), or increasing levels of prostate-specific antigen (PSA) after curative therapy (n = 25) who had been investigated by both Cho-PET/CT and WB-MRI. MRI, CT, and PET images were separately analyzed by experienced radiologists or nuclear medicine experts, followed by consensus reading. Validation was established by histology, follow-up, or consensus reading. Results: 88/103 detected lesions were considered as malignant: 44 bone metastases, 22 local tumor, 15 lymph node metastases, 3 lung, and 3 brain metastases. One further lesion was located in the adrenal gland, which was a second tumor. Overall sensitivity, specificity and accuracy for Cho-PET/CT were 96.6%, 76.5%, and 93.3%, resp., and for WB-MRI 78.4%, 94.1%, and 81.0%, resp. 3 vertebral metastases had initially been missed by Cho-PET/CT and were found retrospectively. MRI identified 2 bone metastases and 1 lymph node metastasis after being informed about the results of Cho-PET/CT. Conclusions: Cho-PET/CT and WB-MRI both presented high accuracy in the detection of bone and lymph node metastases. The strength of MRI is excellent image quality providing detailed anatomical information whereas the advantage of Cho-PET/CT is high image contrast of pathological foci.

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