PT  - JOURNAL ARTICLE
AU  - Chen, Mengxia
AU  - Zhang, Qing
AU  - Zhang, Chengwei
AU  - Zhao, Xiaozhi
AU  - Marra, Giancarlo
AU  - Gao, Jie
AU  - Lv, Xiaoyu
AU  - Zhang, Bing
AU  - Fu, Yao
AU  - Wang, Feng
AU  - Qiu, Xuefeng
AU  - Guo, Hongqian
TI  - Combination of <sup>68</sup>Ga-PSMA PET/CT and Multiparametric MRI Improves the Detection of Clinically Significant Prostate Cancer: A Lesion-by-Lesion Analysis
AID  - 10.2967/jnumed.118.221010
DP  - 2019 Jul 01
TA  - Journal of Nuclear Medicine
PG  - 944--949
VI  - 60
IP  - 7
4099  - http://jnm.snmjournals.org/content/60/7/944.short
4100  - http://jnm.snmjournals.org/content/60/7/944.full
SO  - J Nucl Med2019 Jul 01; 60
AB  - Our purpose was to explore whether 68Ga-PSMA PET/CT alone (PET/CT) or in combination with multiparametric MRI (PET/MRI) can improve the detection of clinically significant prostate cancer (PCa). Methods: We retrospectively enrolled 54 patients who underwent both MRI and PET/CT before radical prostatectomy. Regions of interest on MR images, PET/CT images, and pathologic images were marked. A lesion was defined as a region of interest marked on images obtained with any of the 3 modalities. All lesions were characterized using the prostate imaging reporting and data system (PI-RADS), the molecular imaging PSMA expression score, and the pathologic results and analyzed. Diagnostic performance was analyzed by receiver-operating-characteristic analysis. Specific improvement for lesions with different PI-RADS scores was analyzed using the net reclassification index (NRI). Results: In total, 90 lesions from 54 patients were analyzed, among which 66 lesions represented clinically significant PCa. Receiver-operating-characteristic analysis showed PET/MRI to perform better than MRI in detecting clinically significant PCa (change in area under the curve, 0.06; 95% confidence interval, 0.01–0.12; P < 0.05). With the calculated cutoff, PET/MRI performed significantly better than MRI (NRI, 21.9%; P < 0.01), with an improvement in sensitivity (89% vs. 76%, P < 0.01) at no sacrifice of specificity (96% vs. 88%, P > 0.05). Improvement in diagnosing clinically significant PCa occurred for lesions classified as PI-RADS 3 (NRI, 66.7%; P < 0.01). Conclusion: PET/MRI improves the detection of clinically significant PCa for PI-RADS 3 lesions.