医学
前列腺癌
前列腺切除术
正电子发射断层摄影术
前列腺
放射科
磁共振成像
麦克内马尔试验
曼惠特尼U检验
核医学
生化复发
前列腺特异性抗原
癌症
内科学
数学
统计
作者
Arveen Kalapara,Tatenda Nzenza,Henry Pan,Zita Ballok,Shakher Ramdave,Richard O’Sullivan,Andrew Ryan,Martin H Cherk,Michael S. Hofman,Badrinath R. Konety,Nathan Lawrentschuk,Damien Bolton,Declan Murphy,Jeremy Grummet,Mark Frydenberg
出处
期刊:BJUI
[Wiley]
日期:2020-07-01
卷期号:126 (1): 83-90
被引量:68
摘要
Objective To compare the accuracy of 68 gallium prostate‐specific membrane antigen positron emission tomography/computed tomography ( 68 Ga‐PSMA PET/CT) with multiparametric MRI (mpMRI) in detecting and localising primary prostate cancer when compared with radical prostatectomy (RP) specimen pathology. Patients and methods Retrospective review of men who underwent 68 Ga‐PSMA PET/CT and mpMRI for primary prostate cancer before RP across four centres between 2015 and 2018. Patients undergoing imaging for recurrent disease or before non‐surgical treatment were excluded. We defined pathological index tumour as the lesion with highest International Society of Urological Pathology Grade Group (GG) on RP specimen pathology. Our primary outcomes were rates of accurate detection and localisation of RP specimen pathology index tumour using 68 Ga‐PSMA PET/CT or mpMRI. We defined tumour detection as imaging lesion corresponding with RP specimen tumour on any imaging plane, and localisation as imaging lesion matching RP specimen index tumour in all sagittal, axial, and coronal planes. Secondary outcomes included localisation of clinically significant and transition zone (TZ) index tumours. We defined clinically significant disease as GG 3–5. We used descriptive statistics and the Mann–Whitney U ‐test to define and compare demographic and pathological characteristics between detected, missed and localised tumours using either imaging modality. We used the McNemar test to compare detection and localisation rates using 68 Ga‐PSMA PET/CT and mpMRI. Results In all, 205 men were included in our analysis, including 133 with clinically significant disease. There was no significant difference between 68 Ga‐PSMA PET/CT and mpMRI in the detection of any tumour (94% vs 95%, P > 0.9). There was also no significant difference between localisation of all index tumours (91% vs 89%, P = 0.47), clinically significant index tumours (96% vs 91%, P = 0.15) or TZ tumours (85% vs 80%, P > 0.9) using 68 Ga‐PSMA PET/CT and mpMRI. Limitations include retrospective study design and non‐central review of imaging and pathology. Conclusion We found no significant difference in the detection or localisation of primary prostate cancer between 68 Ga‐PSMA PET/CT and mpMRI. Further prospective studies are required to evaluate a combined PET/MRI model in minimising tumours missed by either modality.
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