期刊
JOURNAL OF NUCLEAR MEDICINE
卷 60, 期 7, 页码 944-949出版社
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.118.221010
关键词
multiparametric MRI; Ga-68-PSMA PET/CT; combination; clinically significant prostate cancer
资金
- National Natural Science Foundation of China [81772710, 81572519, 81602232]
- Natural Science Foundation of Jiangsu Province [BK20150112, BK20150097]
- Nanjing Medical Science and Technique Development Foundation [QRX17128]
- Nanjing Health Distinguished Youth Fund [JQX16025]
- Project of Invigorating Health Care through Science, Technology, and Education, Jiangsu Provincial Key Medical Discipline (Laboratory) [ZDXKB2016014]
Our purpose was to explore whether Ga-68-PSMA PET/CT alone (PET/CT) or in combination with multiparametric MRI (PET/MRI) can improve the detection of clinically significant prostate cancer (PCa). Methods: We retrospectively enrolled 54 patients who underwent both MRI and PET/CT before radical prostatectomy. Regions of interest on MR images, PET/CT images, and pathologic images were marked. A lesion was defined as a region of interest marked on images obtained with any of the 3 modalities. All lesions were characterized using the prostate imaging reporting and data system (PI-RADS), the molecular imaging PSMA expression score, and the pathologic results and analyzed. Diagnostic performance was analyzed by receiver-operating-characteristic analysis. Specific improvement for lesions with different PI-RADS scores was analyzed using the net reclassification index (NRI). Results: In total, 90 lesions from 54 patients were analyzed, among which 66 lesions represented clinically significant PCa. Receiver-operating-characteristic analysis showed PET/MRI to perform better than MRI in detecting clinically significant PCa (change in area under the curve, 0.06; 95% confidence interval, 0.01-0.12; P < 0.05). With the calculated cutoff, PET/MRI performed significantly better than MRI (NRI, 21.9%; P < 0.01), with an improvement in sensitivity (89% vs. 76%, P < 0.01) at no sacrifice of specificity (96% vs. 88%, P > 0.05). Improvement in diagnosing clinically significant PCa occurred for lesions classified as PI-RADS 3 (NRI, 66.7%; P < 0.01). Conclusion: PET/MRI improves the detection of clinically significant PCa for PI-RADS 3 lesions.
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