Comparing the diagnostic value of 68Ga-PSMA PET/CT and multiparameter MRI combined with postoperative whole-mount slides pathology in initial prostate cancer diagnosis
10.3760/cma.j.cn112330-20240517-00233
- VernacularTitle:68Ga-PSMA PET/CT与多参数MRI检查结合术后病理大切片在初诊前列腺癌中的诊断价值比较
- Author:
Zheng LIU
1
;
Fangning WAN
;
Zhe HONG
;
Qifeng WANG
;
Chang LIU
;
Xiaohang LIU
;
Bo DAI
Author Information
1. 复旦大学附属肿瘤医院泌尿外科 复旦大学上海医学院肿瘤学系 上海市泌尿肿瘤研究所，上海 200032
- Keywords:
Prostate cancer;
Whole-mount pathology slides;
68Ga-PSMA PET/CT;
Multiparametric MRI;
Diagnostic efficiency
- From:
Chinese Journal of Urology
2024;45(6):434-438
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the diagnostic performance of 68Ga-PSMA PET/CT and mpMRI in initial staging of prostate cancer. Methods:A retrospective analysis was conducted on patients with initial diagnosis of prostate cancer who underwent prostatectomy at Fudan University Shanghai Cancer Center from December 2021 to June 2023. All had biopsy-confirmed prostate cancer preoperatively and had not undergone any anti-tumor treatment. Prior to surgery, all patients underwent 68Ga-PSMA PET/CT and mpMRI scans. The surgical samples were processed by whole-mount slides pathology. Thirty patients were included, with a median age of 68 years (range 67-76 years). The preoperative median PSA level was 17.91 ng/ml (range 9.41-39.53 ng/ml). The median interval between the two examinations was 21.00 days (range 2.75-35.50 days). Based on the postoperative whole-mount slides pathology which was the gold standard, we compared the sensitivity and specificity of 68Ga-PSMA PET/CT and mpMRI in diagnosing extraprostatic extension, seminal vesicle invasion, and intraprostatic tumor lesion. Results:According to the postoperative pathology, among the 30 patients, 12 had extraprostatic extension (EPE), 8 had seminal vesicle invasion (SVI). Among the 50 lesions found before surgery, postoperative pathology showed that 38 of them were clinically significant prostate cancer lesions (76.0%, 38/50). Using whole-mount pathology, preoperative mpMRI, and 68Ga-PSMA PET/CT imaging for triple fusion comparison, the sensitivity and specificity of 68Ga-PSMA PET/CT in diagnosing EPE were 66.7% (8/12) and 88.9% (16/18), respectively. The sensitivity and specificity of mpMRI in diagnosing EPE were 50.0% (6/12) and 83.3% (15/18), respectively. In diagnosing SVI, the sensitivity and specificity of 68Ga-PSMA PET/CT were 50.0% (4/8) and 86.3% (19/22), respectively. The sensitivity and specificity of mpMRI were 75.0% (6/8) and 90.9% (20/22), respectively. When diagnosing clinically significant tumor lesions within the prostate, the sensitivity of 68Ga-PSMA PET/CT was 89.5% (34/38), which was significantly better than the mpMRI of 63.2% (24/38), with no significant difference in specificity. Conclusions:The sensitivity of 68Ga-PSMA PET/CT in diagnosing intraprostatic lesions was significantly higher than that of mpMRI, with no significant difference in specificity.
