Diagnostic accuracy of


Journal

BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721

Informations de publication

Date de publication:
11 2019
Historique:
pubmed: 10 7 2019
medline: 23 6 2020
entrez: 10 7 2019
Statut: ppublish

Résumé

To evaluate the ability of prostate-specific membrane antigen (PSMA)-positron-emission tomography (PET)/computed tomography (CT) to detect intermediate-grade intra-prostatic prostate cancer (PCa), and to determine if PSMA-PET improves the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI). A total of 56 consecutive patients with International Society of Urological Pathology (ISUP) grade 2-3 PCa after radical prostatectomy, who underwent both mpMRI and PSMA-PET CT (hereafter PSMA-PET) preoperatively, were enrolled in this study. The accuracy of PSMA-PET, mpMRI alone, and the two procedures in combination was analysed for identifying ISUP grades 1-3 within a 12-segment model. The accuracy of a combined predictive model (PSMA-PET and mpMRI) was determined. Receiver-operating characteristic curve analysis to determine the optimal standardized uptake value (SUV On a per-patient basis, the sensitivities for PSMA-PET and mpMRI in identifying ISUP grades 2-3 PCa were 100% and 97%, respectively. Assessing ISUP grade ≥2 PCa using a 12-segment analysis, PSMA-PET demonstrated greater diagnostic accuracy (area under the curve), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV), with values of 0.91, 88%, 93%, 95% and 85%, respectively, than did mpMRI (Prostate Imaging Reporting and Data System [PI-RADS] 3-5), at 0.79, 68%, 91%, 87%, and 75%, respectively. When used in combination (PSMA-PET and mpMRI PIRADS 4-5), sensitivity, specificity, NPV and PPV were 92%, 90%, 96% and 81%, respectively. The sensitivity for both techniques reduced markedly when assessing ISUP grade 1 PCa (18% for PSMA-PET, 10% for mpMRI). An SUV PSMA-PET is accurate in detecting segments containing intermediate-grade intra-prostatic PCa (ISUP grade ≥ 2), compared with and complementary to mpMRI. By contrast the detection rate for ISUP grade 1 disease for both PSMA-PET and mpMRI was low.

Identifiants

pubmed: 31287613
doi: 10.1111/bju.14794
doi:

Substances chimiques

Gallium Radioisotopes 0
Radiopharmaceuticals 0
Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

42-49

Informations de copyright

© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd.

Références

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Auteurs

Matthijs J Scheltema (MJ)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.
Amsterdam UMC, Department of Urology, Amsterdam, The Netherlands.

John I Chang (JI)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.

Phillip D Stricker (PD)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.

Pim J van Leeuwen (PJ)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.
Antoni van Leeuwenhoek Nederlands Kanker Instituut, Amsterdam, The Netherlands.

Quoc A Nguyen (QA)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.

Bao Ho (B)

St Vincent's Hospital Nuclear Medicine and PET Department, Darlinghurst, NSW, Australia.

Warick Delprado (W)

Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia.

Jonathan Lee (J)

St Vincent's Hospital Nuclear Medicine and PET Department, Darlinghurst, NSW, Australia.

James E Thompson (JE)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.

Thomas Cusick (T)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.

Alette S Spriensma (AS)

Amsterdam UMC, Department of Urology, Amsterdam, The Netherlands.

Amila R Siriwardana (AR)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia.

Carlo Yuen (C)

St Vincent's Clinic, Darlinghurst, NSW, Australia.

Raji Kooner (R)

St Vincent's Clinic, Darlinghurst, NSW, Australia.

George Hruby (G)

Genesis Cancer Care, St Vincent's Hospital, Darlinghurst, NSW, Australia.

Gordon O'Neill (G)

St Vincent's Clinic, Darlinghurst, NSW, Australia.

Louise Emmett (L)

Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
St Vincent's Hospital Nuclear Medicine and PET Department, Darlinghurst, NSW, Australia.

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