Lymph Node Assessment in Prostate Cancer: Evaluation of Iodine Quantification With Spectral Detector CT in Correlation to PSMA PET/CT.
Journal
Clinical nuclear medicine
ISSN: 1536-0229
Titre abrégé: Clin Nucl Med
Pays: United States
ID NLM: 7611109
Informations de publication
Date de publication:
01 04 2021
01 04 2021
Historique:
pubmed:
15
1
2021
medline:
7
4
2021
entrez:
14
1
2021
Statut:
ppublish
Résumé
The aims of this study were to evaluate spectral detector CT (SDCT)-derived iodine concentration (IC) of lymph nodes diagnosed as metastatic and benign in prostate-specific membrane antigen (PSMA) PET/CT and to assess its potential use for lymph node assessment in prostate cancer. Thirty-four prostate cancer patients were retrospectively included: 16 patients with and 18 without lymph node metastases as determined by PSMA PET/CT. Patients underwent PSMA PET/CT as well as portal venous phase abdominal SDCT for clinical cancer follow-up. Only scan pairs with a stable nodal status indicated by constant size as well as comparable prostate-specific antigen (PSA) levels were included. One hundred benign and 96 suspected metastatic lymph nodes were annotated and correlated between SDCT and PSMA PET/CT. Iodine concentration in SDCT-derived iodine maps and SUVmax in ultra-high definition reconstructions from PSMA PET/CT were acquired based on the region of interest. Metastatic lymph nodes as per PSMA PET/CT showed higher IC than nonmetastatic nodes (1.9 ± 0.6 mg/mL vs 1.5 ± 0.5 mg/mL, P < 0.05) resulting in an AUC of 0.72 and sensitivity/specificity of 81.3%/58.5%. The mean short axis diameter of metastatic lymph nodes was larger than that of nonmetastatic nodes (6.9 ± 3.6 mm vs 5.3 ± 1.3 mm; P < 0.05); a size threshold of 1 cm short axis diameter resulted in a sensitivity/specificity of 12.8%/99.0%. There was a significant yet weak positive correlation between SUVmax and IC (rs = 0.25; P < 0.001). Spectral detector CT-derived IC was increased in lymph nodes diagnosed as metastatic in PSMA PET/CT yet showed considerable data overlap. The correlation between IC and SUVmax was weak, highlighting the role of PSMA PET/CT as important reference imaging modality for detection of lymph node metastases in prostate cancer patients.
Identifiants
pubmed: 33443954
doi: 10.1097/RLU.0000000000003496
pii: 00003072-202104000-00005
doi:
Substances chimiques
Antigens, Surface
0
Iodine Radioisotopes
0
FOLH1 protein, human
EC 3.4.17.21
Glutamate Carboxypeptidase II
EC 3.4.17.21
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-309Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest and sources of funding: Parts of this study have been supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) within the Priority Programme SPP 2177 Radiomics (PE 1711/2-1 to T.P.) and the Else Kröner-Fresenius-Stiftung (2016-Kolleg-19 to S.L. and EKMS_2018.34 to N.G.H.). A.D. received research support (material transfer) and speaker honorary from and is consulting for GE Healthcare; received research support from Life Molecular Imaging; received research support (material transfer), speaker honorary, and stock from and is consulting for Siemens Healthineers; and received research support (material transfer) from AVID/Lilly. The patent is pending for PET tracer PSMA-7. D.M. and N.G.H. received speaker honorary from Philips Healthcare. S.L., N.G.H., and D.Z. received research support from Philips Healthcare. No other potential conflicts of interest relevant to this article exist.
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