医学
前列腺癌
淋巴结
PET-CT
心脏成像
放射科
肿瘤科
内科学
癌症
正电子发射断层摄影术
作者
Jacob Ingvar,Erland Hvittfeldt,Elin Trägårdh,Athanasios Simoulis,Anders Bjartell
标识
DOI:10.1186/s13550-022-00918-7
摘要
[18F]PSMA-1007 is a promising tracer for integrated positron emission tomography and computed tomography (PET/CT).Our aim was to assess the diagnostic accuracy of [18F]PSMA-1007 PET/CT for primary staging of lymph node metastasis before robotic-assisted laparoscopy (RALP) with extended lymph node dissection (ePLND).The study was a retrospective cohort in a tertiary referral center. Men with prostate cancer that underwent surgical treatment for intermediate- or high-risk prostate cancer between May 2019 and August 2021 were included.[18F]PSMA-1007 PET/CT for initial staging followed by RALP and ePLND.Sensitivity and specificity were calculated both for the entire cohort and for patients with lymph node metastasis ≥ 3 mm. Positive (PPV) and negative (NPV) predictive values were calculated.Among 104 patients included in the analyses, 26 patients had lymph node metastasis based on pathology reporting and metastases were ≥ 3 mm in size in 13 of the cases (50%). In the entire cohort, the sensitivity and specificity of [18F]PSMA-1007 were 26.9% (95% confidence interval (CI); 11.6-47.8) and 96.2% (95% CI; 89.2-99.2), respectively. The sensitivity and specificity of [18F]PSMA-1007 to detect a lymph node metastasis ≥ 3 mm on PET/CT were 53.8% (95% CI; 25.1-80.8) and 96.7% (95% CI; 90.7-99.3), respectively. PPV was 70% and NPV 93.6%.In primary staging of intermediate- and high-risk prostate cancer, [18F]PSMA-1007 PET/CT is highly specific for prediction of lymph node metastases, but the sensitivity for detection of metastases smaller than 3 mm is limited. Based on our results, [18F]PSMA-1007 PET/CT cannot completely replace ePLND. This study investigated the use of an imaging method based on a prostate antigen-specific radiopharmaceutical tracer to detect lymph node prostate cancer metastasis. We found that it is unreliable to discover small metastasis.
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