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Whole-Body Integrated [68Ga]PSMA-11-PET/MR Imaging in Patients with Recurrent Prostate Cancer: Comparison with Whole-Body PET/CT as the Standard of Reference

  • Nika GuberinaEmail author
  • P. Hetkamp
  • H. Ruebben
  • W. Fendler
  • J. Grueneisen
  • S. Suntharalingam
  • J. Kirchner
  • L. Puellen
  • N. Harke
  • J. P. Radtke
  • L. Umutlu
  • B. A. Hadaschik
  • K. Herrmann
  • M. Forsting
  • A. Wetter
Review Article
  • 80 Downloads

Abstract

Purpose

The aim of this study was to evaluate the detection rate of [68Ga]prostate-specific membrane antigen ([68Ga]PSMA-11) positron emission tomography (PET)/magnetic resonance imaging (MRI) and to compare it with [68Ga]PSMA-11 PET/X-ray computed tomography (CT) in patients with recurrent prostate cancer (PC) after radical prostatectomy.

Procedures

A total of 93 patients with biochemically recurrent prostate cancer underwent [68Ga]PSMA-11 PET/CT and subsequently a whole-body integrated PET/MRI examination. Board certified nuclear medicine physicians and radiologists evaluated PET/CT and PET/MRI datasets regarding identification of tumor lesions ((i) lymph nodes, (ii) bone lesions, (iii) local recurrence, and (iv) parenchymal lesions) based on maximum [68Ga]PSMA-11 uptake as well as morphological changes. Quality of PET images for both PET/CT and PET/MRI were rated using a 5-point scoring system by evaluating lesion homogeneity, contrast, contour, and delineation. Wilcoxon signed-rank tests were used to determine statistical differences.

Results

PC relapse was detected in 62/93 patients. PET/MRI detected 148 out of 150 lesions described in PET/CT. In addition, PET/MRI detected 11 lesions not detected in PET/CT (5 lymph nodes, 6 local recurrences). The exact McNemar statistical test (one-sided) showed significant difference between PET/CT and PET/MRI for diagnosis of local recurrence (p value = 0.031). Diagnostic confidence for (iii) was higher in PET/MRI compared with PET/CT (PET/CT = 1.1; PET/MRI = 4.9). Diagnostic confidence for (i) (PET/CT = 4.9; PET/MRI = 4.6), (ii) (PET/CT = 4.9; PET/MRI = 4.6), and (iv) (PET/CT = 4.6; PET/MRI = 4.8) was equivalent between PET/MRI and PET/CT.

Conclusions

Integrated [68Ga]PSMA-11 PET/MRI provides a similarly high diagnostic performance for localization of recurrent PC as PET/CT. For the detection of local recurrences [68Ga]PSMA-11 PET/MRI is superior compared with [68Ga]PSMA-11 PET/CT.

Key words

[68Ga]PSMA-11 PET/MRI Recurrent prostate cancer Whole-body MRI staging PSA relapse 

Notes

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

BH reports grants from German Cancer Aid, German Research Foundation, and Profound Medical, grants, personal fees, and nonfinancial support from Janssen, personal fees and nonfinancial support from Astellas, Bayer, BMS, Lightpoint Medical, Astra Zeneca, and Sanofi, and grants and personal fees from Uromed, all outside the submitted work.

JPR is a company consultant for Saegeling Medizintechnik, Invivo Uronav, Philips, Siemens Healthineers, Beckelmann, and Bender and reports grants from Medical faculty Heidelberg, all outside the submitted work.

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Copyright information

© World Molecular Imaging Society 2019

Authors and Affiliations

  • Nika Guberina
    • 1
    • 2
    Email author
  • P. Hetkamp
    • 3
  • H. Ruebben
    • 4
  • W. Fendler
    • 3
  • J. Grueneisen
    • 1
  • S. Suntharalingam
    • 1
  • J. Kirchner
    • 5
  • L. Puellen
    • 4
  • N. Harke
    • 4
  • J. P. Radtke
    • 4
  • L. Umutlu
    • 1
  • B. A. Hadaschik
    • 4
  • K. Herrmann
    • 3
  • M. Forsting
    • 1
  • A. Wetter
    • 1
  1. 1.Department of Diagnostic and Interventional Radiology and NeuroradiologyUniversity Hospital EssenEssenGermany
  2. 2.Department for RadiotherapyUniversity Hospital EssenEssenGermany
  3. 3.Clinic of Nuclear MedicineUniversity Hospital EssenEssenGermany
  4. 4.Department of UrologyUniversity Hospital EssenEssenGermany
  5. 5.Department of Diagnostic and Interventional RadiologyUniversity Hospital DüsseldorfDüsseldorfGermany

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