학술논문
Correlation of [SUV.sub.max] and Apparent Diffusion Coefficient Values Detected by Ga-68 PSMA PET/MRI in Primary Prostate Lesions and Their Significance in Lymph Node Metastasis: Preliminary Results of an On-going Study/Ga-68 PSMA PET/MRG ile Tespit Edilen Primer Prostat Lezyonlarinda [SUV.sub.maks] ve Gorunur Difuzyon Katsayisi Degerlerinin Korelasyonu ve Lenf Nodu Metastazlarinda Onemi: Devam Eden Klinik Calismanin On Bulgulari
Original Article
Original Article
Document Type
Academic Journal
Author
Source
Molecular Imaging and Radionuclide Therapy. October 2019, Vol. 28 Issue 3, p104, 8 p.
Subject
Language
English
ISSN
2146-1414
Abstract
Introduction Prostate cancer is the second most common diagnosed cancer in men and the fifth leading cause of cancer-related death worldwide (1). Death rates are lower in developed countries, due [...]
Objectives: Gallium-68 (Ga-68) prostate specific membrane antigen (PSMA) positron emission tomography (PET) has been shown to be more accurate than multiparametric prostate magnetic resonance imaging (MRI) in detection of primary prostate lesions. Using hybrid PET/MRI we aim to detect the correlation between [SUV.sub.max] and apparent diffusion coefficient (ADC) in primary prostate lesions and to assess their prognostic value in detection of lymph node (LN) metastasis. Methods: Twenty-six patients, who were diagnosed as having prostate cancer with biopsy and underwent Ga-68 PSMA PET/MRI together with biparametric prostate MRI (bpMRI) were included. [SUV.sub.max], [SUV.sub.mean] and ADC were recorded for index lesions drawing a region of interest (ROI) of 1 [cm.sup.2] around the pixel with the highest [SUV.sub.max] (ROI-1) and another ROI following borders of prostate tumor detected by bpMRI (ROI-2). Presence of LN metastasis was recorded according to PSMA PET/MRI. Results: [SUV.sub.max] was inversely correlated with ADC (ROI-1: p=0.010; ROI-2: p=0.017 for b=800). [SUV.sub.max] and [SUV.sub.means] were both higher in patients with LN metastasis and ADC was lower in patients with LN metastasis for ROI-1. [SUV.sub.max] cut-off value of 19.8 for ROI-1 and 20.9 for ROI-2 had sensitivity and specificity of 77.8% and 76.5%, respectively for detection of LN metastasis, whereas ADC (b=800) cut-off value of 0.92x[10.sup.-3] [mm.sup.2]/s had sensitivity and specificity of 87.5% and 76.5%, respectively. [SUV.sub.max]/ADC (b=800) ratio increased the sensitivity and specificity to 100% and 82.4%, respectively. Conclusion: SUV and ADC values are inversely correlated in primary prostate lesions and the combined use of both values increases the diagnostic accuracy of hybrid PET/MRI in the detection of primary prostate lesions. Keywords: Gallium-68, prostate specific membrane antigen, positron emission tomography/magnetic resonance imaging, multiparametric prostate magnetic resonance imaging, prostate cancer, lymph node metastasis Amac: Galyum-68 (Ga-68) prostat spesifik membran antijeni (PSMA) pozitron emisyon tomografinin (PET) primer prostat lezyonunu saptamada multiparametrik prostat manyetik rezonans goruntulemeden (MRG) daha dogru oldugu gosterilmistir. Hibrit PET/MRG kullanarak primer prostat lezyonlarinda [SUV.sub.maks] ve gorunur difuzyon katsayisi (ADC) arasindaki korelasyonu tespit etmeyi ve lenf nodu (LN) metastazi tespitinde prognostik degerlerini saptamayi amacliyoruz. Yontem: Biyopsi ile prostat kanseri tanisi almis, biparametrik prostat MRG (bpMRG) ile birlikte Ga-68 PSMA PET/MRG yapilmis 26 hasta calismaya alindi. Indeks lezyonlarin [SUV.sub.mak], [SUV.sub.ortalama] ve ADC degerleri, hem en yuksek [SUV.sub.mak] olan piksel etrafinda 1 [cm.sup.2] capinda ilgi alani (ROI) cizerek (ROI-1) hem de bpMRI tarafindan tespit edilen prostat tumorunun sinirlarini takip eden bir baska ROI cizerek (ROI-2) kaydedildi. LN metastazi varligi PSMA PET/MRG'ye gore belirlendi. Bulgular: [SUV.sub.maks] ve ADC arasinda ters korelasyon saptandi (b=800 icin ROI-1: p=0,010; ROI-2: p=0,017). [SUV.sub.maks] ve [SUV.sub.ortalama] degerleri LN metastazli hastalarda daha yuksek bulundu ve ADC degeri ROI-1 icin LN metastazli hastalarda daha dusuktu. [SUV.sub.maks] sinir degeri ROI-1 icin 19,8 ve ROI-2 icin 20,9 alindiginda LN metastazinin saptanmasinda duyarlilik ve ozgulluk sirasiyla %77,8 ve %76,5 olarak bulundu. Buna karsilik ADC (b=800) sinir degeri 0,92x[10.sup.3] [mm.sup.2]/s alindiginda duyarlilik ve ozgulluk sirasiyla %87,5 ve %76,5 olarak saptandi. [SUV.sub.maks] /ADC (b=800) orani, duyarliligi ve ozgullugu sirasiyla %100 ve %82,4'e yukseltti. Sonuc: SUV ve ADC degerleri primer prostat lezyonlarinda ters korelasyon gosterir ve her iki degerin birlikte kullanimi primer prostat lezyonlarinin tespitinde hibrit PET/MRG'nin tanisal dogrulugunu arttirir. Anahtar kelimeler: Galyum-68, prostat spesifik membran antijeni, pozitron emisyon tomografi/manyetik rezonans goruntuleme, multiparametrik prostat manyetik rezonans goruntuleme, prostat kanseri, lenf nodu metastazi
Objectives: Gallium-68 (Ga-68) prostate specific membrane antigen (PSMA) positron emission tomography (PET) has been shown to be more accurate than multiparametric prostate magnetic resonance imaging (MRI) in detection of primary prostate lesions. Using hybrid PET/MRI we aim to detect the correlation between [SUV.sub.max] and apparent diffusion coefficient (ADC) in primary prostate lesions and to assess their prognostic value in detection of lymph node (LN) metastasis. Methods: Twenty-six patients, who were diagnosed as having prostate cancer with biopsy and underwent Ga-68 PSMA PET/MRI together with biparametric prostate MRI (bpMRI) were included. [SUV.sub.max], [SUV.sub.mean] and ADC were recorded for index lesions drawing a region of interest (ROI) of 1 [cm.sup.2] around the pixel with the highest [SUV.sub.max] (ROI-1) and another ROI following borders of prostate tumor detected by bpMRI (ROI-2). Presence of LN metastasis was recorded according to PSMA PET/MRI. Results: [SUV.sub.max] was inversely correlated with ADC (ROI-1: p=0.010; ROI-2: p=0.017 for b=800). [SUV.sub.max] and [SUV.sub.means] were both higher in patients with LN metastasis and ADC was lower in patients with LN metastasis for ROI-1. [SUV.sub.max] cut-off value of 19.8 for ROI-1 and 20.9 for ROI-2 had sensitivity and specificity of 77.8% and 76.5%, respectively for detection of LN metastasis, whereas ADC (b=800) cut-off value of 0.92x[10.sup.-3] [mm.sup.2]/s had sensitivity and specificity of 87.5% and 76.5%, respectively. [SUV.sub.max]/ADC (b=800) ratio increased the sensitivity and specificity to 100% and 82.4%, respectively. Conclusion: SUV and ADC values are inversely correlated in primary prostate lesions and the combined use of both values increases the diagnostic accuracy of hybrid PET/MRI in the detection of primary prostate lesions. Keywords: Gallium-68, prostate specific membrane antigen, positron emission tomography/magnetic resonance imaging, multiparametric prostate magnetic resonance imaging, prostate cancer, lymph node metastasis Amac: Galyum-68 (Ga-68) prostat spesifik membran antijeni (PSMA) pozitron emisyon tomografinin (PET) primer prostat lezyonunu saptamada multiparametrik prostat manyetik rezonans goruntulemeden (MRG) daha dogru oldugu gosterilmistir. Hibrit PET/MRG kullanarak primer prostat lezyonlarinda [SUV.sub.maks] ve gorunur difuzyon katsayisi (ADC) arasindaki korelasyonu tespit etmeyi ve lenf nodu (LN) metastazi tespitinde prognostik degerlerini saptamayi amacliyoruz. Yontem: Biyopsi ile prostat kanseri tanisi almis, biparametrik prostat MRG (bpMRG) ile birlikte Ga-68 PSMA PET/MRG yapilmis 26 hasta calismaya alindi. Indeks lezyonlarin [SUV.sub.mak], [SUV.sub.ortalama] ve ADC degerleri, hem en yuksek [SUV.sub.mak] olan piksel etrafinda 1 [cm.sup.2] capinda ilgi alani (ROI) cizerek (ROI-1) hem de bpMRI tarafindan tespit edilen prostat tumorunun sinirlarini takip eden bir baska ROI cizerek (ROI-2) kaydedildi. LN metastazi varligi PSMA PET/MRG'ye gore belirlendi. Bulgular: [SUV.sub.maks] ve ADC arasinda ters korelasyon saptandi (b=800 icin ROI-1: p=0,010; ROI-2: p=0,017). [SUV.sub.maks] ve [SUV.sub.ortalama] degerleri LN metastazli hastalarda daha yuksek bulundu ve ADC degeri ROI-1 icin LN metastazli hastalarda daha dusuktu. [SUV.sub.maks] sinir degeri ROI-1 icin 19,8 ve ROI-2 icin 20,9 alindiginda LN metastazinin saptanmasinda duyarlilik ve ozgulluk sirasiyla %77,8 ve %76,5 olarak bulundu. Buna karsilik ADC (b=800) sinir degeri 0,92x[10.sup.3] [mm.sup.2]/s alindiginda duyarlilik ve ozgulluk sirasiyla %87,5 ve %76,5 olarak saptandi. [SUV.sub.maks] /ADC (b=800) orani, duyarliligi ve ozgullugu sirasiyla %100 ve %82,4'e yukseltti. Sonuc: SUV ve ADC degerleri primer prostat lezyonlarinda ters korelasyon gosterir ve her iki degerin birlikte kullanimi primer prostat lezyonlarinin tespitinde hibrit PET/MRG'nin tanisal dogrulugunu arttirir. Anahtar kelimeler: Galyum-68, prostat spesifik membran antijeni, pozitron emisyon tomografi/manyetik rezonans goruntuleme, multiparametrik prostat manyetik rezonans goruntuleme, prostat kanseri, lenf nodu metastazi