Three-dimensional spatial localization and volume estimation of prostate tumors using 18F-PSMA-1007 PET/CT versus multiparametric MRI,European Journal of Nuclear Medicine and Molecular Imaging

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Three-dimensional spatial localization and volume estimation of prostate tumors using 18F-PSMA-1007 PET/CT versus multiparametric MRI
European Journal of Nuclear Medicine and Molecular Imaging ( IF 8.6 ) Pub Date : 2024-12-27 , DOI: 10.1007/s00259-024-07021-0
Guocheng Huang, Patrick Albers, Nikhile Mookerji, Tyler Pfanner, Amaris Hui, Rohan Mittal, Stacey Broomfield, Lucas Dean, Blair St. Martin, Niels-Erik Jacobsen, Howard Evans, Yuan Gao, Ryan Hung, Jonathan Abele, Peter Dromparis, Joema Felipe Lima, Tarek A. Bismar, Evangelos Michelakis, Gopinath Sutendra, Frank Wuest, Wendy Tu, Benjamin A. Adam, Christopher Fung, Sunita Ghosh, Alexander Tamm, Adam Kinnaird

Purpose

Fluorine-18 prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (¹⁸F-PSMA-1007 PET/CT) has been shown to be superior to multiparametric magnetic resonance imaging (MRI) for the locoregional staging of intermediate-risk and high-risk prostate tumors. This study aims to evaluate whether it is also superior in estimating tumor parameters, such as three-dimensional spatial localization and volume.

Methods

134 participants underwent ¹⁸F-PSMA-1007 PET/CT and MRI prior to radical prostatectomy as part of the validating paired-cohort Next Generation Trial (NCT05141760). MRI, ¹⁸F-PSMA-1007 PET/CT, and final pathology were independently assessed by blinded radiologists, nuclear medicine physicians, and pathologists, respectively. Individual tumor nodules were measured in three dimensions and cognitively registered to 38 segment prostate diagrams as per PI-RADSv2.1. Correct spatial localization was compared using McNemar test and estimation of tumor volumes were compared using linear regression and partial F-test.

Results

286 tumor nodules were identified by final histopathology. ¹⁸F-PSMA-1007 PET/CT was superior to MRI for correct localization (186 [65.0%] vs 134 [46.9%], p < 0.001) and tumor volume estimation (R² = 0.545 vs 0.431, p < 0.001). Larger tumors and higher Gleason Grade Group (GGG) were associated with correct localization by ¹⁸F-PSMA-1007 PET/CT (OR = 2.05, p < 0.001 for tumor volume and OR = 4.92, p < 0.01 for ≥ GGG3) and MRI (OR = 1.81, p < 0.001 for tumor volume and OR = 11.67, p < 0.001 for ≥ GGG3).

Conclusion

¹⁸F-PSMA-1007 PET/CT outperforms MRI for determination of three-dimensional spatial localization and volume of prostate tumors. These findings support the use of ¹⁸F-PSMA-1007 PET/CT prior to definitive treatment of localized prostate cancers.

中文翻译：

使用 18F-PSMA-1007 PET/CT 与多参数 MRI 对前列腺肿瘤进行三维空间定位和体积估计

目的

氟-18 前列腺特异性膜抗原-1007 正电子发射断层扫描/计算机断层扫描（¹⁸F-PSMA-1007 PET/CT）已被证明在中危和高风险前列腺肿瘤的局部区域分期中优于多参数磁共振成像（MRI）。本研究旨在评估它在估计肿瘤参数（例如三维空间定位和体积）方面是否也更优越。

方法

作为验证配对队列下一代试验（NCT05141760）的一部分，134 名参与者在根治性前列腺切除术前接受了 ¹⁸次 F-PSMA-1007 PET/CT 和 MRI 检查。MRI 、 ¹⁸F-PSMA-1007 PET/CT 和最终病理分别由盲法放射科医生、核医学医师和病理学家独立评估。根据 PI-RADSv2.1 对单个肿瘤结节进行三维测量，并在认知上配准到 38 段前列腺图。使用 McNemar 检验比较正确的空间定位，并使用线性回归和部分 F 检验比较肿瘤体积的估计。

结果

通过最终组织病理学鉴定出 286 个肿瘤结节。¹⁸F-PSMA-1007 PET/CT 在正确定位（186 [65.0%] vs 134 [46.9%]，p < 0.001）和肿瘤体积估计（R² = 0.545 vs 0.431，p < 0.001）方面优于 MRI。较大的肿瘤和较高的格里森分级组（GGG）与 ¹⁸F-PSMA-1007 PET/CT （OR = 2.05，肿瘤体积 p < 0.001，≥ GGG3 的 p < 0.001）和 MRI 的正确定位相关（OR = 1.81，肿瘤体积 p < 0.001 和 OR = 11.67，≥ GGG3 的 p < 0.001）。