Research ArticleClinical Investigations

68Ga-PSMA PET/CT Detects the Location and Extent of Primary Prostate Cancer

Wolfgang P. Fendler, Dorothea F. Schmidt, Vera Wenter, Kolja M. Thierfelder, Christian Zach, Christian Stief, Peter Bartenstein, Thomas Kirchner, Franz J. Gildehaus, Christian Gratzke and Claudius Faber
Journal of Nuclear Medicine November 2016, 57 (11) 1720-1725; DOI: https://doi.org/10.2967/jnumed.116.172627

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    SUVmax for histopathology-positive (HP+) or -negative (HP−) segments. (A) HP+ segments were further categorized by GS. Single values are given for each segment (n = 126); mean for each category is shown by bars. Results from Mann–Whitney test are given (*P < 0.05). (B) SUVmax was tested for accuracy in discrimination of HP+ from HP− segments. Receiver-operating-characteristic curve, area under curve (AUC), and optimal SUVmax cutoff as determined by Youden index are given.

  • FIGURE 2.
    FIGURE 2.

    False-negative PET finding for acinar adenocarcinoma with partial neuroendocrine differentiation. 68Ga-PSMA PET/CT image (A), PSMA-stained slice (B), and hematoxylin-stained slice (C) for left mid (LM) and right mid (RM) segments are shown. PET SUVmax was 9.9 (true-positive) in LM segment. Tumor tissue with neuroendocrine differentiation and strong expression of neuroendocrine markers (chromogranin A, CD56; not shown) is delineated by black dots in RM segment. SUVmax was 5.5 (false-negative) in RM segment based on absence of PSMA expression in neuroendocrine prostate cancer lesions. STBPET3 (SUV ≥ 3.6) was 55% in LM segment (histopathology, 100%) and is delineated by red line.

  • FIGURE 3.
    FIGURE 3.

    Scatterplot for STB in PET-positive segments as determined by STBPET3 and STBHP. STBPET3 is based on (2 × blood SUV) + (2 × SD cutoff). Regression line (±SD) and results from Pearson test are given. n = 69.

  • FIGURE 4.
    FIGURE 4.

    68Ga-PSMA PET/CT performance in 21 patients. Patients were grouped by optimal SUVmax cutoff as PET-positive or PET-negative. PET-positive patients were further parsed into those for whom PET and histopathology indicated highest STB in same glandular segment (maximum STB match) or in different segments (maximum STB mismatch).

Tables

  • TABLE 1

    Accuracy of 68Ga-PSMA PET for Detection of Tumor Tissue per Segment

    PET resultHP+ (n = 100)HP− (n = 26)Accuracy
    PET+ (n = 69)672Positive predictive value, 97%
    PET− (n = 57)3324Negative predictive value, 42%
    Sensitivity, 67%Specificity, 92%Accuracy, 72%

    • HP = histopathology.

    • Six segments from 21 patients were analyzed.

  • TABLE 2

    Correlation Between STBHP and STBPET1–6 in PET-Positive Segments (n = 69)

    ParameterSTBPET1STBPET2STBPET3STBPET4STBPET5STBPET6
    AlgorithmPERCISTLiver SUV(2 × blood SUV) + (2 × SD)(2 × blood SUV) + (4 × SD)Parotid SUV/2Parotid SUV/3
    Pearson ρ0.620.660.68‡0.650.400.47
    P<0.001*<0.001*<0.001*<0.001*0.001*<0.001*
    Mean Δ ± SD28% ± 22%22% ± 18%19% ± 15%†19% ± 17%33% ± 28%25% ± 23%

    • ↵* P < 0.05.

    • ↵† Highest ρ and lowest mean Δ ± SD.

  • TABLE 3

    Accuracy of 68Ga-PSMA PET/CT for Detection of Histopathologically Proven (HP+) Invasion of Seminal Vesicles

    PET resultHP+ (n = 11)HP− (n = 10)Accuracy
    PET+ (n = 8)80Positive predictive value, 100%
    PET− (n = 13)310Negative predictive value, 77%
    Sensitivity, 73%Specificity, 100%Accuracy, 86%

    • HP = histopathology.

Additional Files

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools
Bookmark this article

Jump to section

Related Articles

Cited By...

More in this TOC Section

Similar Articles

Keywords