Simultaneous Whole-body PET/MRI with Integrated Multiparametric MRI for Primary Staging of High-risk Prostate Cancer

Overview

Journal World J Urol

Specialty Urology

Date 2020 Jan 8

PMID 31907632

Citations 8

Authors

Sascha Kaufmann

Stephan Kruck

Sergios Gatidis

Tobias Hepp

Wolfgang M Thaiss

Jorg Hennenlotter

Johannes Schwenck

Marcus Scharpf

Konstantin Nikolaou

Arnulf Stenzl

Gerald Reischl

Christian La Fougere

Jens Bedke

Affiliations

Soon will be listed here.

Abstract

Purpose: Whole-body positron emission tomography/magnetic resonance imaging (wbPET/MRI) is a promising diagnostic tool of recurrent prostate cancer (PC), but its role in primary staging of high-risk PC (hrPC) is not well defined. Thus, the aim was to compare the diagnostic accuracy for T-staging of PET-blinded reading (PBR) and PET/MRI.

Methods: In this prospective study, hrPC patients scheduled to radical prostatectomy (RPx) with extended lymphadenectomy (eLND) were staged with wbPET/MRI and either Ga-PSMA-11 or C-choline including simultaneous multiparametric MRI (mpMRI). Images were assessed in two sessions, first as PBR (mpMRI and wbMRI) and second as wbPET/MRI. Prostate Imaging Reporting and Data System criteria (PIRADS v2) were used for T-staging. Results were correlated with the exact anatomical localization and extension as defined by histopathology. Diagnostic accuracy of cTNM stage according to PBR was compared to pathological pTNM stage as reference standard.

Results: Thirty-four patients underwent wbPET/MRI of Ga-PSMA-11 (n = 17) or C-choline (n = 17). Twenty-four patients meeting the inclusion criteria of localized disease ± nodal disease based on imaging results underwent RPx and eLND, whereas ten patients were excluded from analysis due to metastatic disease. T-stage was best defined by mpMRI with underestimation of tumor lesion size by PET for both tracers. N-stage yielded a per patient sensitivity/specificity comparable to PBR.

Conclusion: MpMRI is the primary modality for T-staging in hrPC as PET underestimated T-stage in direct comparison to final pathology. In this selected study, cohort MRI shows no inferiority compared to wbPET/MRI considering N-staging.

Citing Articles

Whole-body magnetic resonance imaging for staging patients with high-risk prostate cancer.

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Ma J, Yang Q, Ye X, Xu W, Chang Y, Chen R Eur Radiol. 2023; 34(6):4017-4037.

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Gossili F, Mogensen A, Konnerup T, Bouchelouche K, Alberts I, Afshar-Oromieh A Eur J Nucl Med Mol Imaging. 2023; 51(1):281-294.

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Preliminary Results of an Ongoing Prospective Clinical Trial on the Use of Ga-PSMA and Ga-DOTA-RM2 PET/MRI in Staging of High-Risk Prostate Cancer Patients.

Mapelli P, Ghezzo S, Samanes Gajate A, Preza E, Brembilla G, Cucchiara V Diagnostics (Basel). 2021; 11(11).

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Molecular Imaging in Primary Staging of Prostate Cancer Patients: Current Aspects and Future Trends.

Manafi-Farid R, Ranjbar S, Jamshidi Araghi Z, Pilz J, Schweighofer-Zwink G, Pirich C Cancers (Basel). 2021; 13(21).

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