Article Figures & Data
Figures
- FIGURE 1.
ROC curves for 68Ga-PSMA HBED-CC PET imaging (red) and morphologic imaging (CT/MR) (blue) for detection of LNM on a field-based analysis (P values: comparison to AUC = 0.5).
- FIGURE 2.
Example of a 55-y-old patient with biochemical recurrence after radical prostatectomy (Gleason score, 7; PSA level at PET examination, 0.77 ng/mL) and a correctly classified LNM by 68Ga-PSMA HBED-CC PET imaging: a 6-mm LN is visible in right obturator fossa on CT imaging (A, arrow) that shows intense, focal and thus suspicious tracer uptake on 68Ga-PSMA HBED-CC PET (B) and PET/CT fusion imaging (C). Salvage lymphadenectomy with histologic evaluation confirmed a single LNM.
- FIGURE 3.
68Ga-PSMA HBED-CC PET imaging of a 55-y-old patient with recurrent PC (Gleason score, 8; PSA level at PET examination, 5.1 ng/mL). Patient presented with 2 correctly classified LNM (5 and 6 mm) behind left common iliac artery with intense, focal uptake on 68Ga-PSMA HBED-CC PET/CT fusion (B, arrow) and on maximum-intensity-projection images (C, arrow). However, paraaortal/interaortocaval LN field was negative on 68Ga-PSMA HBED-CC PET, showing no increased uptake either on maximum-intensity-projection images (C) or on axial 68Ga-PSMA HBED-CC PET/CT (E). In conventional CT imaging, only small, unsuspicious LNs could be found (D, arrow). Histopathology revealed overall 9 further LNM in this anatomic field (paraaortic).
Tables
- TABLE 1
Total Number and Location of Resected LN Fields and Histopathologically Proven LNM
LN fields No. of resected fields No. of histopathologically proven LNM % of histopathologically proven LNM Level 1 right common iliac vessel 18 6 33.3 Level 2 left common iliac vessel 22 7 31.8 Level 3 right internal iliac vessel 16 4 25 Level 4 left internal iliac vessel 20 9 45 Level 5 right external iliac vessel 17 6 35.3 Level 6 left external iliac vessel 19 9 47.4 Level 7 right obturator fossa 18 7 38.9 Level 8 left obturator fossa 18 3 16.7 Level 9 presacral 13 9 69.2 Level 10 others 18 8 44.4 Histology: LNM Results Positive Negative Diagnostic accuracy 68Ga-PSMA HBED-CC PET rating Positive 53 3 PPV, 94.6% Negative 15 108 NPV, 87.8% Total 68 111 179 Sensitivity, 77.9% Specificity, 97.3% Accuracy, 89.9% Morphologic rating (CT/MR) Positive 18 1 PPV, 94.7% Negative 49 110 NPV, 69.2% Total 67 111 178 Sensitivity, 26.9% Specificity, 99.1% Accuracy, 71.9% PPV = positive predictive value; NPV = negative predictive value.
Histology: LNM Results Positive Negative Diagnostic accuracy 68Ga-PSMA HBED-CC PET rating Positive 42 3 PPV, 93.3% Negative 0 3 NPV, 100% Total 42 6 48 Sensitivity, 100% Specificity, 50% Accuracy, 93.8% Morphologic rating (CT/MR) Positive 14 1 PPV, 93.3% Negative 27 5 NPV, 84.3% Total 41 6 47 Sensitivity, 34.1% Specificity, 83.3% Accuracy, 40.4% PPV = positive predictive value; NPV = negative predictive value.
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