Article Figures & Data
Figures
- FIGURE 1.
A 62-y-old man with Gleason 3 + 4 PC in right lateral base and Gleason 3 + 3 PC in right posterior base (A shows color-coded needle tracks from biopsy; green: benign, yellow: Gleason 3 + 3, red: Gleason ≥ 3 + 4). He presented with PSA of 7.0 ng/mL and PSA density of 0.24 ng/mL2. Pretherapy 68Ga-RM2 (B) and 68Ga-PSMA-11 (C) axial PET/MRI and PET, respectively, show focal uptake in right prostate lesion (red arrows). This was treated with HIFU, and 6 mo later, uptake resolved on 68Ga-RM2 (D) and 68Ga-PSMA11 (E) axial PET/MRI and PET, respectively. Focal uptake in left prostate (blue arrows) was subsequently biopsied and showed nonaggressive PC. U = urethra with excreted 68Ga-RM2.
Tables
Characteristic Data n 14 Age (y) 64.50 ± 8.00 (48.00–78.00) PSA (ng/mL) 8.41 ± 3.47 (1.22–15.90) PSA density (ng/mL2) 0.23 ± 0.09 (0.07–0.31) mpMRI 18 lesions PI-RADS 5 3 (17%) PI-RADS 4 11 (61%) PI-RADS 3 4 (22%) Biopsy, Gleason grade 18 lesions 1 3 (17%) 2 5 (28%) 3 7 (39%) 4 2 (11%) 5 1 (5%) Risk Intermediate 13 High 1 Clinical stage T1c 5 T2a 2 T2b 4 T2c 3 68Ga-PSMA11 Injected activity (MBq) 151.33 ± 44.80 (70.30–222.00) Uptake time (min) 46.50 ± 3.50 (44.00–57.00) Length of PET/MRI (min) 49.00 ± 16.96 (30.00–83.00) Delay to pelvic PET/MRI (min) 23.00 ± 9.19 (22.00–49.00) 68Ga-RM2 Injected activity (MBq) 138.80 ± 4.61 (132.98–150.20) Uptake time (min) 45.50 ± 2.12 (43.00–52.00) Length of PET/MRI (min) 47.00 ± 6.58 (36.00–60.00) Delay to pelvic PET/MRI (min) 25.00 ± 5.54 (11.00–37.00) Time between scans (d) 5.50 ± 2.50 (2.00–9.00) Qualitative data are number and percentage; continuous data are median ± SD and range.
Characteristic Data n 14 PSA (ng/mL) 2.83 ± 1.65 (0.02–5.79) PSA density (ng/mL2) 0.07 ± 0.04 (0.00–0.17) PSA nadir (ng/mL) 2.80 ± 1.48 (0.01–5.79) Time to PSA nadir (mo) 6.55 ± 5.92 (2.90–24.83) Biopsy (n = 13) Residual lesions Clinically significant 1 Clinically insignificant 3 Recurrent lesions Clinically significant 3 Clinically insignificant 6 68Ga-PSMA11 Injected activity (MBq) 145.60 ± 37.75 (82.51–221.26) Uptake time (min) 47.50 ± 2.40 (41.00–49.00) Length of PET/MRI (min) 45.50 ± 5.90 (33.00–62.00) Delay to pelvic PET/MRI (min) 26.00 ± 6.53 (22.00–48.00) 68Ga-RM2 Injected activity (MBq) 139.77 ± 5.04 (133.32–149.67) Uptake time (min) 46.00 ± 3.14 (39.00–52.00) Length of PET/MRI (min) 51.50 ± 9.53 (41.00–73.00) Delay to pelvic PET/MRI (min) 26.00 ± 6.22 (21.00–47.00) Time between scans (d) 5.00 ± 40.66 (2.00–172.00) Time between pre- and post-HIFU scans (mo) 7.43 ± 2.37 (5.93–12.60) Qualitative data are number and percentage; continuous data are median ± SD and range.
- TABLE 3.
Direct Comparison of mpMRI, 68Ga-PSMA11, and 68Ga-RM2 PET/MRI Findings Before and After HIFU Ablation
mpMRI 68Ga-PSMA11 68Ga-RM2 Parameter Before HIFU After HIFU Before HIFU After HIFU Before HIFU After HIFU All lesions (n) 18 (PI-RADS 3: 4; PI-RADS 4: 11; PI-RADS 5: 3) 5 (PI-RADS 3: 4; PI-RADS 4: 1) 23 9 (2 residual; 7 recurrent) 23 9 (1 residual; 8 recurrent) Target lesions 14 9/13 patients: negative; 3/13 patients: PI-RADS 3 (1 csPC, 2 ncsPC) 14 2 residual (1 csPC; 2 ncsPC) 12 1 residual (1 csPC) Sensitivity 43% 81% 70% Specificity 98% 89% 88% - TABLE 4.
SUVmax and SUVpeak of Target Lesions in Whole Body and Delayed Pelvic 68Ga-PSMA11 and 68Ga-RM2 PET/MRI Before and After HIFU Ablation
68Ga-PSMA11 68Ga-RM2 Parameter Whole body Delayed pelvic Whole body Delayed pelvic Before HIFU, SUVmax 9.51 (6.63–18.50) 8.91 (6.66–18.94) 7.70 (5.67–11.05) 7.48 (4.97–11.51) After HIFU SUVmax 2.27 (1.80–2.78) 2.03 (1.80–2.51) 2.55 (2.07–3.48) 2.61 (1.68–2.74) P 0.001 0.001 0.005 0.006 Before HIFU, SUVpeak 5.04 (3.97–8.84) 5.16 (4.27–9.50) 5.22 (4.15–8.05) 4.96 (4.02–8.57) After HIFU SUVpeak 1.96 (1.89–2.31) 2.11 (1.83–2.39) 3.06 (2.85–3.49) 2.81 (2.22–3.08) P 0.012 0.068 0.026 0.084 Data are median and interquartile range.
