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Prospective comparison of 68Ga-PSMA PET/CT, 18F-sodium fluoride PET/CT and diffusion weighted-MRI at for the detection of bone metastases in biochemically recurrent prostate cancer

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Zacho, Helle D ; Nielsen, Julie B ; Afshar-Oromieh, Ali ; Haberkorn, Uwe ; deSouza, Nandita ; De Paepe, Katja ; Dettmann, Katja ; Langkilde, Niels C ; Haarmark, Christian ; Fisker, Rune V ; Arp, Dennis T ; Carl, Jesper ; Jensen, Jørgen B ; Petersen, Lars J. / Prospective comparison of 68Ga-PSMA PET/CT, 18F-sodium fluoride PET/CT and diffusion weighted-MRI at for the detection of bone metastases in biochemically recurrent prostate cancer. I: European Journal of Nuclear Medicine and Molecular Imaging. 2018 ; Bind 45, Nr. 11. s. 1884-1897.

Bibtex

@article{6b86a98fc98f49c5a60970a6abaed3cf,
title = "Prospective comparison of 68Ga-PSMA PET/CT, 18F-sodium fluoride PET/CT and diffusion weighted-MRI at for the detection of bone metastases in biochemically recurrent prostate cancer",
abstract = "PURPOSE: To prospectively compare diagnostic accuracies for detection of bone metastases by 68Ga-PSMA PET/CT, 18F-NaF PET/CT and diffusion-weighted MRI (DW600-MRI) in prostate cancer (PCa) patients with biochemical recurrence (BCR).METHODS: Sixty-eight PCa patients with BCR participated in this prospective study. The patients underwent 68Ga-PSMA PET/CT, a 18F-NaF PET/CT and a DW600-MRI (performed in accordance with European Society of Urogenital Radiology guidelines, with b values of 0 and 600 s/mm2). Bone lesions were categorized using a three-point scale (benign, malignant or equivocal for metastases) and a dichotomous scale (benign or metastatic) for each imaging modality by at least two experienced observers. A best valuable comparator was defined for each patient based on study-specific imaging, at least 12 months of clinical follow-up and any imaging prior to the study and during follow-up. Diagnostic performance was assessed using a sensitivity analysis where equivocal lesions were handled as non-metastatic and then as metastatic.RESULTS: Ten of the 68 patients were diagnosed with bone metastases. On a patient level, sensitivity, specificity and the area under the curve (AUC) by receiver operating characteristic analysis were, respectively, 0.80, 0.98-1.00 and 0.89-0.90 for 68Ga-PSMA PET/CT (n = 68 patients); 0.90, 0.90-0.98 and 0.90-0.94 for 18NaF PET/CT (n = 67 patients); and 0.25-0.38, 0.87-0.92 and 0.59-0.62 for DW600-MRI (n = 60 patients). The diagnostic performance of DW600-MRI was significantly lower than that of 68Ga-PSMA PET/CT and 18NaF PET/CT for diagnosing bone metastases (p < 0.01), and no significant difference in the AUC was seen between 68Ga-PSMA PET/CT and 18NaF PET/CT (p = 0.65).CONCLUSION: 68Ga-PSMA PET/CT and 18F-NaF PET/CT showed comparable and high diagnostic accuracies for detecting bone metastases in PCa patients with BCR. Both methods performed significantly better than DW600-MRI, which was inadequate for diagnosing bone metastases when conducted in accordance with European Society of Urogenital Radiology guidelines.",
keywords = "Aged, Aged, 80 and over, Bone Neoplasms/diagnostic imaging, Diffusion Magnetic Resonance Imaging, Edetic Acid/analogs & derivatives, Fluorine Radioisotopes, Humans, Male, Middle Aged, Oligopeptides, Positron Emission Tomography Computed Tomography, Prospective Studies, Prostatic Neoplasms/metabolism, Recurrence, Sodium Fluoride",
author = "Zacho, {Helle D} and Nielsen, {Julie B} and Ali Afshar-Oromieh and Uwe Haberkorn and Nandita deSouza and {De Paepe}, Katja and Katja Dettmann and Langkilde, {Niels C} and Christian Haarmark and Fisker, {Rune V} and Arp, {Dennis T} and Jesper Carl and Jensen, {J{\o}rgen B} and Petersen, {Lars J}",
year = "2018",
month = oct,
doi = "10.1007/s00259-018-4058-4",
language = "English",
volume = "45",
pages = "1884--1897",
journal = "European Journal Of Nuclear Medicine",
issn = "1619-7070",
publisher = "Springer",
number = "11",

}

RIS

TY - JOUR

T1 - Prospective comparison of 68Ga-PSMA PET/CT, 18F-sodium fluoride PET/CT and diffusion weighted-MRI at for the detection of bone metastases in biochemically recurrent prostate cancer

AU - Zacho, Helle D

AU - Nielsen, Julie B

AU - Afshar-Oromieh, Ali

AU - Haberkorn, Uwe

AU - deSouza, Nandita

AU - De Paepe, Katja

AU - Dettmann, Katja

AU - Langkilde, Niels C

AU - Haarmark, Christian

AU - Fisker, Rune V

AU - Arp, Dennis T

AU - Carl, Jesper

AU - Jensen, Jørgen B

AU - Petersen, Lars J

PY - 2018/10

Y1 - 2018/10

N2 - PURPOSE: To prospectively compare diagnostic accuracies for detection of bone metastases by 68Ga-PSMA PET/CT, 18F-NaF PET/CT and diffusion-weighted MRI (DW600-MRI) in prostate cancer (PCa) patients with biochemical recurrence (BCR).METHODS: Sixty-eight PCa patients with BCR participated in this prospective study. The patients underwent 68Ga-PSMA PET/CT, a 18F-NaF PET/CT and a DW600-MRI (performed in accordance with European Society of Urogenital Radiology guidelines, with b values of 0 and 600 s/mm2). Bone lesions were categorized using a three-point scale (benign, malignant or equivocal for metastases) and a dichotomous scale (benign or metastatic) for each imaging modality by at least two experienced observers. A best valuable comparator was defined for each patient based on study-specific imaging, at least 12 months of clinical follow-up and any imaging prior to the study and during follow-up. Diagnostic performance was assessed using a sensitivity analysis where equivocal lesions were handled as non-metastatic and then as metastatic.RESULTS: Ten of the 68 patients were diagnosed with bone metastases. On a patient level, sensitivity, specificity and the area under the curve (AUC) by receiver operating characteristic analysis were, respectively, 0.80, 0.98-1.00 and 0.89-0.90 for 68Ga-PSMA PET/CT (n = 68 patients); 0.90, 0.90-0.98 and 0.90-0.94 for 18NaF PET/CT (n = 67 patients); and 0.25-0.38, 0.87-0.92 and 0.59-0.62 for DW600-MRI (n = 60 patients). The diagnostic performance of DW600-MRI was significantly lower than that of 68Ga-PSMA PET/CT and 18NaF PET/CT for diagnosing bone metastases (p < 0.01), and no significant difference in the AUC was seen between 68Ga-PSMA PET/CT and 18NaF PET/CT (p = 0.65).CONCLUSION: 68Ga-PSMA PET/CT and 18F-NaF PET/CT showed comparable and high diagnostic accuracies for detecting bone metastases in PCa patients with BCR. Both methods performed significantly better than DW600-MRI, which was inadequate for diagnosing bone metastases when conducted in accordance with European Society of Urogenital Radiology guidelines.

AB - PURPOSE: To prospectively compare diagnostic accuracies for detection of bone metastases by 68Ga-PSMA PET/CT, 18F-NaF PET/CT and diffusion-weighted MRI (DW600-MRI) in prostate cancer (PCa) patients with biochemical recurrence (BCR).METHODS: Sixty-eight PCa patients with BCR participated in this prospective study. The patients underwent 68Ga-PSMA PET/CT, a 18F-NaF PET/CT and a DW600-MRI (performed in accordance with European Society of Urogenital Radiology guidelines, with b values of 0 and 600 s/mm2). Bone lesions were categorized using a three-point scale (benign, malignant or equivocal for metastases) and a dichotomous scale (benign or metastatic) for each imaging modality by at least two experienced observers. A best valuable comparator was defined for each patient based on study-specific imaging, at least 12 months of clinical follow-up and any imaging prior to the study and during follow-up. Diagnostic performance was assessed using a sensitivity analysis where equivocal lesions were handled as non-metastatic and then as metastatic.RESULTS: Ten of the 68 patients were diagnosed with bone metastases. On a patient level, sensitivity, specificity and the area under the curve (AUC) by receiver operating characteristic analysis were, respectively, 0.80, 0.98-1.00 and 0.89-0.90 for 68Ga-PSMA PET/CT (n = 68 patients); 0.90, 0.90-0.98 and 0.90-0.94 for 18NaF PET/CT (n = 67 patients); and 0.25-0.38, 0.87-0.92 and 0.59-0.62 for DW600-MRI (n = 60 patients). The diagnostic performance of DW600-MRI was significantly lower than that of 68Ga-PSMA PET/CT and 18NaF PET/CT for diagnosing bone metastases (p < 0.01), and no significant difference in the AUC was seen between 68Ga-PSMA PET/CT and 18NaF PET/CT (p = 0.65).CONCLUSION: 68Ga-PSMA PET/CT and 18F-NaF PET/CT showed comparable and high diagnostic accuracies for detecting bone metastases in PCa patients with BCR. Both methods performed significantly better than DW600-MRI, which was inadequate for diagnosing bone metastases when conducted in accordance with European Society of Urogenital Radiology guidelines.

KW - Aged

KW - Aged, 80 and over

KW - Bone Neoplasms/diagnostic imaging

KW - Diffusion Magnetic Resonance Imaging

KW - Edetic Acid/analogs & derivatives

KW - Fluorine Radioisotopes

KW - Humans

KW - Male

KW - Middle Aged

KW - Oligopeptides

KW - Positron Emission Tomography Computed Tomography

KW - Prospective Studies

KW - Prostatic Neoplasms/metabolism

KW - Recurrence

KW - Sodium Fluoride

U2 - 10.1007/s00259-018-4058-4

DO - 10.1007/s00259-018-4058-4

M3 - Journal article

C2 - 29876619

VL - 45

SP - 1884

EP - 1897

JO - European Journal Of Nuclear Medicine

JF - European Journal Of Nuclear Medicine

SN - 1619-7070

IS - 11

ER -

ID: 56147261