Assessing the accuracy of [18F]PSMA-1007 PET/CT for primary staging of lymph node metastases in intermediate- and high-risk prostate cancer patients
(2022) In EJNMMI Research 12(1).- Abstract
Background: [18F]PSMA-1007 is a promising tracer for integrated positron emission tomography and computed tomography (PET/CT). Objective: 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). Design, Setting and Participants: 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. Interventions: [18F]PSMA-1007 PET/CT for initial staging followed by RALP and ePLND. Outcome measurements and... (More)
Background: [18F]PSMA-1007 is a promising tracer for integrated positron emission tomography and computed tomography (PET/CT). Objective: 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). Design, Setting and Participants: 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. Interventions: [18F]PSMA-1007 PET/CT for initial staging followed by RALP and ePLND. Outcome measurements and statistical analyses: 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. Results and limitations: 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%. Conclusions: 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. Patient summary: 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.
(Less)
- author
- Ingvar, Jacob LU ; Hvittfeldt, Erland LU ; Trägårdh, Elin LU ; Simoulis, Athanasios LU and Bjartell, Anders LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Lymph node dissection, Metastases, PET/CT, Prostate cancer, Robotic surgery, Staging
- in
- EJNMMI Research
- volume
- 12
- issue
- 1
- article number
- 48
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:35943665
- scopus:85135802117
- ISSN
- 2191-219X
- DOI
- 10.1186/s13550-022-00918-7
- language
- English
- LU publication?
- yes
- id
- fa5a4c64-e585-41d3-be9b-c368255d1c76
- date added to LUP
- 2022-09-23 11:35:05
- date last changed
- 2024-09-18 09:39:38
@article{fa5a4c64-e585-41d3-be9b-c368255d1c76, abstract = {{<p>Background: [<sup>18</sup>F]PSMA-1007 is a promising tracer for integrated positron emission tomography and computed tomography (PET/CT). Objective: Our aim was to assess the diagnostic accuracy of [<sup>18</sup>F]PSMA-1007 PET/CT for primary staging of lymph node metastasis before robotic-assisted laparoscopy (RALP) with extended lymph node dissection (ePLND). Design, Setting and Participants: 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. Interventions: [<sup>18</sup>F]PSMA-1007 PET/CT for initial staging followed by RALP and ePLND. Outcome measurements and statistical analyses: 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. Results and limitations: 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 [<sup>18</sup>F]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 [<sup>18</sup>F]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%. Conclusions: In primary staging of intermediate- and high-risk prostate cancer, [<sup>18</sup>F]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, [<sup>18</sup>F]PSMA-1007 PET/CT cannot completely replace ePLND. Patient summary: 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.</p>}}, author = {{Ingvar, Jacob and Hvittfeldt, Erland and Trägårdh, Elin and Simoulis, Athanasios and Bjartell, Anders}}, issn = {{2191-219X}}, keywords = {{Lymph node dissection; Metastases; PET/CT; Prostate cancer; Robotic surgery; Staging}}, language = {{eng}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{EJNMMI Research}}, title = {{Assessing the accuracy of [<sup>18</sup>F]PSMA-1007 PET/CT for primary staging of lymph node metastases in intermediate- and high-risk prostate cancer patients}}, url = {{http://dx.doi.org/10.1186/s13550-022-00918-7}}, doi = {{10.1186/s13550-022-00918-7}}, volume = {{12}}, year = {{2022}}, }