Grubmüller, B; Baltzer, P; Hartenbach, S; D'Andrea, D; Helbich, TH; Haug, AR; Goldner, GM; Wadsak, W; Pfaff, S; Mitterhauser, M; Balber, T; Berroteran-Infante, N; Grahovac, M; Babich, J; Seitz, C; Kramer, G; Susani, M; Mazal, P; Kenner, L; Shariat, SF; Hacker, M; Hartenbach, M
PSMA Ligand PET/MRI for Primary Prostate Cancer: Staging Performance and Clinical Impact
Clin Cancer Res. 2018; 24(24): 6300-6307.
Autor/innen der Vetmeduni Vienna:
Institut für Pathologie, Abteilung für Labortierpathologie
- Primary staging of prostate cancer relies on modalities, which are limited. We evaluate simultaneous [68Ga]Ga-PSMA-11 PET (PSMA-PET)/MRI as a new diagnostic method for primary tumor-node-metastasis staging compared with histology and its impact on therapeutic decisions.We investigated 122 patients with PSMA-PET/MRI prior to planned radical prostatectomy (RP). Primary endpoint was the accuracy of PSMA-PET/MRI in tumor staging as compared with staging-relevant histology. In addition, a multidisciplinary team reassessed the initial therapeutic approach to evaluate its impact on the therapeutic management.PSMA-PET/MRI correctly identified prostate cancer in 119 of 122 patients (97.5%). Eighty-one patients were treated with RP and pelvic lymphadenectomy. The accuracy for T staging was 82.5% [95% confidence interval (CI), 73-90; P< 0.001], for T2 stage was 85% (95% CI, 71-94; P< 0.001), for T3a stage was 79% (95% CI, 43-85; P< 0.001), for T3b stage was 94% (95% CI, 73-100; P< 0.001), and for N1 stage was 93% (95% CI, 84-98; P< 0.001). PSMA-PET/MRI changed the therapeutic strategy in 28.7% of the patients with either the onset of systemic therapy/radiotherapy (n = 16) or active surveillance (n = 19).PSMA-PET/MRI can provide an accurate staging of newly diagnosed prostate cancer. In addition, treatment strategies were changed in almost a third of the patients due to the information of this hybrid imaging technique.©2018 American Association for Cancer Research.
Magnetic Resonance Imagingmethodsstandards