Abstract
Purpose
Treatment of primary prostate cancer extremely depends on preoperative stage. The role of 18F-1007-PSMA-PET/CT in preoperative staging has not been well defined. Our aim was to compare the diagnostic performance of 18F-1007-PEMA-PET/CT, mpMRI, and mpMRI + PEMA-PET/CT in local progression and lymph node invasion of prostate cancer using histopathology as the gold standard.
Materials and methods
In this retrospective study, all patients with prostate cancer who underwent mpMRI and 18F-PSMA-1007-PET/CT before operation were included. The role of preoperative imaging was evaluated by predicting the sensitivity and specificity of EPE (extraprostatic extension), SVI (seminal vesicle invasion), and lymph node invasion results.
Results
Ultimately, 130 patients were included in this study. In the preoperative judgment of EPE and SVI, mpMRI + PSMA-PET/CT had higher sensitivity and specificity. When predicting lymph node metastasis, PSMA-PET/CT was the best choice. The accuracy of mpMRI + PSMA-PET/CT and PSMA-PET/CT in the T and N stages, respectively, was affected by the least factors.
Conclusions
Based on the combined results of mpMRI and 18F-1007-PSMA-PET/CT, the accuracy of the preoperative judgment of prostatic capsule invasion can be improved, which may be conducive to developing intra-fascial technology while ensuring no tumor-touch isolation. PSMA-PET/CT has the advantages over mpMRI alone in terms of lymph node positivity. Compared with PSMA-PET/CT alone, the combined results can improve the sensitivity, but reduce specificity. Therefore, it is recommended to focus on PSMA-PET/CT to decide whether lymph node dissection should be performed.
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Data availability
We have uploaded an additional table to Supplementary Material, which shows all relevant statistical data.
Change history
17 May 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00345-023-04431-x
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Funding
This research was supported by Zhejiang Provincial Natural Science Foundation of China under Grant No. LQ20H050001 and LY20H160013.
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YT: conceptualization, methodology, software, formal analysis, investigation, writing—original draft, visualization. XJ: methodology, formal analysis, investigation, writing—original draft. QL: conceptualization, validation, data curation, writing—review & editing, project administration. HH: validation, data curation, writing—review & editing, project administration, funding acquisition. HZ: validation, investigation. XH: validation, investigation. HX: writing—review & editing, supervision. WC: writing—review & editing, supervision, funding acquisition. YZ: conceptualization, methodology, formal analysis, investigation, writing—original draft.
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345_2023_4345_MOESM1_ESM.tiff
Supplementary file1 T and N stage of mpMRI and PSMA-PET/CT and every patient correspongding pathological diagnosis. (A) T stage for each patients of the two methods and pathological results (each line corresponds to the same patient). (B)N stage for each patients of the two methods and pathological results (each line corresponds to the same patient) (TIFF 653 kb)
345_2023_4345_MOESM2_ESM.xlsx
Supplementary file2 a patient diagnosed with T2 and N0 stage by mpMRI. (A) T2 weighted image (T2WI) showed hypo intense signal on the peripheral zone (B) Diffusion-weighted imaging (DWI) showed a restricted diffusion (C) Apparent diffusion coefficient (ADC) showed a decreased lesion (D) An additional T2WI image which anatomically matched to Figure 1 showed no evidence of lymph node metastasis (XLSX 40 kb)
345_2023_4345_MOESM3_ESM.tif
Supplementary file3 The relationship between accuracy of different imaging diagnostic methods and patient-related information. X axis represents different imaging methods and Y axis represents different related factors. (*: p<0.05 ; **: p<0.01) (TIF 13332 kb)
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Tang, Y., Ji, X., Lin, Q. et al. Status of 18F-PSMA-1007-PET/CT compared with multiparametric MRI in preoperative evaluation of prostate cancer. World J Urol 41, 1017–1024 (2023). https://doi.org/10.1007/s00345-023-04345-8
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DOI: https://doi.org/10.1007/s00345-023-04345-8