68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer

Christoph Alexander J. von Klot; Axel S. Merseburger; Alena Böker; Sebastian Schmuck; Tobias L. Ross; Frank M. Bengel; Markus A. Kuczyk; Christoph Henkenberens; Hans Christiansen; Hans Jürgen Wester; Wiebke Solass; Marcel Lafos; Thorsten Derlin

doi:10.1007/s13139-017-0476-7

⁶⁸Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer

Christoph Alexander J. von Klot
, Axel S. Merseburger
, Alena Böker
, Sebastian Schmuck
, Tobias L. Ross
, Frank M. Bengel
, Markus A. Kuczyk
, Christoph Henkenberens
, Hans Christiansen
, Hans Jürgen Wester
, Wiebke Solass
, Marcel Lafos
, Thorsten Derlin

Associate Professorship of Pharmaceutical Radiochemistry

Medizinische Hochschule Hannover
Universitätsklinikum Schleswig-Holstein Campus Lübeck

Research output: Contribution to journal › Article › peer-review

59 Scopus citations

Abstract

Purpose: ⁶⁸Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I&T (imaging and therapy) PET/CT prior to radical prostatectomy. Methods: The study population consisted of 21 patients with prostate cancer who underwent ⁶⁸Ga-PSMA I&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology. Results: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUV_mean of the primary tumors was 9.5 ± 8.8. SUV_mean was higher in tumors with ECE than in organ-confined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (r_s = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7%, 75.0%, 97.3% and 60.0% for tumor infiltration of an individual prostate lobe, 75.0%, 100.0%, 100.0% and 97.4% for SVI, and 90.0%, 90.9%, 90.0% and 90.9% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from ⁶⁸Ga-PSMA I&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (r_p = 0.75, p < 0.001) and tumor volume on histopathology (r_p = 0.45, p = 0.039). Conclusions: ⁶⁸Ga-PSMA I&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, ⁶⁸Ga-PSMA I&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI.

Original language	English
Pages (from-to)	314-322
Number of pages	9
Journal	Nuclear Medicine and Molecular Imaging
Volume	51
Issue number	4
DOIs	https://doi.org/10.1007/s13139-017-0476-7
State	Published - 1 Dec 2017

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Extracapsular extension
PET/CT
Prostate cancer
Prostate-specific membrane antigen (PSMA)
Seminal vesicle
Staging

Access to Document

10.1007/s13139-017-0476-7

Cite this

von Klot, C. A. J., Merseburger, A. S., Böker, A., Schmuck, S., Ross, T. L., Bengel, F. M., Kuczyk, M. A., Henkenberens, C., Christiansen, H., Wester, H. J., Solass, W., Lafos, M., & Derlin, T. (2017). ⁶⁸Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer. Nuclear Medicine and Molecular Imaging, 51(4), 314-322. https://doi.org/10.1007/s13139-017-0476-7

@article{eb3681d1dd6a4e6188d3b3e72bda6518,

title = "68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer",

abstract = "Purpose: 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I\&T (imaging and therapy) PET/CT prior to radical prostatectomy. Methods: The study population consisted of 21 patients with prostate cancer who underwent 68Ga-PSMA I\&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology. Results: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUVmean of the primary tumors was 9.5 ± 8.8. SUVmean was higher in tumors with ECE than in organ-confined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (rs = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7\%, 75.0\%, 97.3\% and 60.0\% for tumor infiltration of an individual prostate lobe, 75.0\%, 100.0\%, 100.0\% and 97.4\% for SVI, and 90.0\%, 90.9\%, 90.0\% and 90.9\% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from 68Ga-PSMA I\&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (rp = 0.75, p < 0.001) and tumor volume on histopathology (rp = 0.45, p = 0.039). Conclusions: 68Ga-PSMA I\&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, 68Ga-PSMA I\&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI.",

keywords = "Extracapsular extension, PET/CT, Prostate cancer, Prostate-specific membrane antigen (PSMA), Seminal vesicle, Staging",

author = "\{von Klot\}, \{Christoph Alexander J.\} and Merseburger, \{Axel S.\} and Alena B{\"o}ker and Sebastian Schmuck and Ross, \{Tobias L.\} and Bengel, \{Frank M.\} and Kuczyk, \{Markus A.\} and Christoph Henkenberens and Hans Christiansen and Wester, \{Hans J{\"u}rgen\} and Wiebke Solass and Marcel Lafos and Thorsten Derlin",

note = "Publisher Copyright: {\textcopyright} 2017, Korean Society of Nuclear Medicine.",

year = "2017",

month = dec,

day = "1",

doi = "10.1007/s13139-017-0476-7",

language = "English",

volume = "51",

pages = "314--322",

journal = "Nuclear Medicine and Molecular Imaging",

issn = "1869-3474",

publisher = "Springer Verlag",

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von Klot, CAJ, Merseburger, AS, Böker, A, Schmuck, S, Ross, TL, Bengel, FM, Kuczyk, MA, Henkenberens, C, Christiansen, H, Wester, HJ, Solass, W, Lafos, M & Derlin, T 2017, '⁶⁸Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer', Nuclear Medicine and Molecular Imaging, vol. 51, no. 4, pp. 314-322. https://doi.org/10.1007/s13139-017-0476-7

⁶⁸Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer. / von Klot, Christoph Alexander J.; Merseburger, Axel S.; Böker, Alena et al.
In: Nuclear Medicine and Molecular Imaging, Vol. 51, No. 4, 01.12.2017, p. 314-322.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 68Ga-PSMA PET/CT Imaging Predicting Intraprostatic Tumor Extent, Extracapsular Extension and Seminal Vesicle Invasion Prior to Radical Prostatectomy in Patients with Prostate Cancer

AU - von Klot, Christoph Alexander J.

AU - Merseburger, Axel S.

AU - Böker, Alena

AU - Schmuck, Sebastian

AU - Ross, Tobias L.

AU - Bengel, Frank M.

AU - Kuczyk, Markus A.

AU - Henkenberens, Christoph

AU - Christiansen, Hans

AU - Wester, Hans Jürgen

AU - Solass, Wiebke

AU - Lafos, Marcel

AU - Derlin, Thorsten

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose: 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I&T (imaging and therapy) PET/CT prior to radical prostatectomy. Methods: The study population consisted of 21 patients with prostate cancer who underwent 68Ga-PSMA I&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology. Results: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUVmean of the primary tumors was 9.5 ± 8.8. SUVmean was higher in tumors with ECE than in organ-confined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (rs = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7%, 75.0%, 97.3% and 60.0% for tumor infiltration of an individual prostate lobe, 75.0%, 100.0%, 100.0% and 97.4% for SVI, and 90.0%, 90.9%, 90.0% and 90.9% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from 68Ga-PSMA I&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (rp = 0.75, p < 0.001) and tumor volume on histopathology (rp = 0.45, p = 0.039). Conclusions: 68Ga-PSMA I&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, 68Ga-PSMA I&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI.

AB - Purpose: 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) has shown promising results in patients with biochemical recurrence after primary therapy for prostate cancer. In this study, we evaluated the usefulness of PSMA I&T (imaging and therapy) PET/CT prior to radical prostatectomy. Methods: The study population consisted of 21 patients with prostate cancer who underwent 68Ga-PSMA I&T PET/CT before either open or laparoscopic radical prostatectomy. Intraprostatic tumor extent, extracapsular extension (ECE) and seminal vesicle invasion (SVI) were assessed on the PET/CT scans. Tracer uptake was quantified in terms of standardized uptake values (SUVs). Imaging findings were correlated with final whole-gland histopathology. Results: Of the 21 patients, two had T stage 2b disease, nine stage 2c, six stage 3a and four stage 3b. The median Gleason score was 7. The SUVmean of the primary tumors was 9.5 ± 8.8. SUVmean was higher in tumors with ECE than in organ-confined tumors (13.8 ± 11.0 vs. 5.6 ± 3.2, p = 0.029). Peak tracer uptake was significantly positively correlated with Gleason score (rs = 0.49, p = 0.025). Sensitivity, specificity, positive predictive value and negative predictive value were, respectively, 94.7%, 75.0%, 97.3% and 60.0% for tumor infiltration of an individual prostate lobe, 75.0%, 100.0%, 100.0% and 97.4% for SVI, and 90.0%, 90.9%, 90.0% and 90.9% for ECE, using an angulated contour of the prostate as the criterion. Tumor volume derived from 68Ga-PSMA I&T PET/CT was significantly correlated with preoperative prostate-specific antigen value (rp = 0.75, p < 0.001) and tumor volume on histopathology (rp = 0.45, p = 0.039). Conclusions: 68Ga-PSMA I&T PET/CT prior to radical prostatectomy can contribute to presurgical local staging of prostate cancer. In this pilot study, 68Ga-PSMA I&T PET/CT showed promising results for prediction of lobe infiltration, ECE and SVI.

KW - Extracapsular extension

KW - PET/CT

KW - Prostate cancer

KW - Prostate-specific membrane antigen (PSMA)

KW - Seminal vesicle

KW - Staging

UR - https://www.scopus.com/pages/publications/85028177044

U2 - 10.1007/s13139-017-0476-7

DO - 10.1007/s13139-017-0476-7

M3 - Article

AN - SCOPUS:85028177044

SN - 1869-3474

VL - 51

SP - 314

EP - 322

JO - Nuclear Medicine and Molecular Imaging

JF - Nuclear Medicine and Molecular Imaging

IS - 4

ER -