TY - JOUR T1 - Diagnostic Accuracy of <sup>18</sup>F-PSMA-1007 PET/CT Imaging for Lymph Node Staging of Prostate Carcinoma in Primary and Biochemical Recurrence JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 208 LP - 213 DO - 10.2967/jnumed.120.246363 VL - 62 IS - 2 AU - Katharina Sprute AU - Vasko Kramer AU - Stefan A. Koerber AU - Manuel Meneses AU - Rene Fernandez AU - Cristian Soza-Ried AU - Mathias Eiber AU - Wolfgang A. Weber AU - Isabel Rauscher AU - Kambiz Rahbar AU - Michael Schaefers AU - Tadashi Watabe AU - Motohide Uemura AU - Sadahiro Naka AU - Norio Nonomura AU - Jun Hatazawa AU - Constantin Schwab AU - Viktoria Schütz AU - Markus Hohenfellner AU - Tim Holland-Letz AU - Juergen Debus AU - Clemens Kratochwil AU - Horacio Amaral AU - Pete L. Choyke AU - Uwe Haberkorn AU - Camilo Sandoval AU - Frederik L. Giesel Y1 - 2021/02/01 UR - http://jnm.snmjournals.org/content/62/2/208.abstract N2 - Prostate-specific membrane antigen (PSMA)–ligand PET/CT is performed on patients with prostate cancer to stage the disease initially or to identify sites of recurrence after definitive therapy. On the basis of clinical results, 18F-PSMA-1007 is a promising PSMA PET tracer, but detailed histologic confirmation has been lacking. Methods: Ninety-six patients with prostate cancer underwent 18F-PSMA-1007 PET/CT followed by either radical prostatectomy with lymphadenectomy or salvage lymphadenectomy. The histologic findings of PSMA PET–positive nodes were analyzed retrospectively. A lesion-based and patient-based analysis was performed comparing all positive lesions and only lesions larger than 3 mm on histopathology. Results: Of the patients, 90.6% received 18F-PSMA-1007 PET/CT for staging before the primary treatment, whereas 9.4% underwent imaging for biochemical recurrence. In 34.4% of the cohort, positive lymph nodes were present on imaging. In total, 1,746 lymph nodes were dissected in 96 patients. 18F-PSMA-1007 PET had a lesion-based sensitivity of 81.7%, a specificity of 99.6%, a positive predictive value of 92.4%, and a negative predictive value of 98.9% for detecting positive lymph nodes larger than 3 mm. In the analysis of all malignant nodes regardless of size, the overall sensitivity, specificity, positive predictive value, and negative predictive value on lesion-based analysis were 71.2%, 99.5%, 91.3%, and 97.9%, respectively. The patient-based analysis showed a sensitivity of 85.9% and a specificity of 99.5% for lymph nodes larger than 3 mm. Conclusion: 18F-PSMA-1007 PET/CT reliably detects malignant lymph nodes and has an exceptional specificity of more than 99% for nodal metastases. ER -