TY - JOUR
T1 - 68
Ga-PSMA-PET/CT in comparison with
18
F-fluoride-PET/CT and whole-body MRI for the detection of bone metastases in patients with prostate cancer
T2 - a prospective diagnostic accuracy study
AU - Dyrberg, Eva
AU - Hendel, Helle W.
AU - Huynh, Tri Hien Viet
AU - Klausen, Tobias Wirenfeldt
AU - Løgager, Vibeke B.
AU - Madsen, Claus
AU - Pedersen, Erik M.
AU - Pedersen, Maria
AU - Thomsen, Henrik S.
PY - 2019
Y1 - 2019
N2 -
Objectives: To determine the diagnostic accuracy of
68
gallium prostate-specific membrane antigen (PSMA)-based positron emission tomography/computed tomography (PET/CT) in comparison with
18
F-fluoride-based PET/CT (NaF-PET/CT) and whole-body magnetic resonance imaging (WB-MRI) for the detection of bone metastases in patients with prostate cancer. Methods: Sixty patients with prostate cancer were included in the period May 2016 to June 2017. The participants underwent three scans (index tests) within 30 days: a NaF-PET/CT, a WB-MRI and a PSMA-PET/CT. Experienced specialists assessed the scans. In the absence of a histological reference standard, the final diagnosis was determined as a panel diagnosis. Measures of the diagnostic performances of the index tests were calculated from patient-based dichotomous outcomes (0 or ≥ 1 bone metastasis) and pairwise compared (McNemar test). For each index test, the agreement with the final diagnosis with regard to the number of bone metastases detected (0, 1–5, > 5) and the inter-reader agreement was calculated (kappa coefficients). Results: Fifty-five patients constituted the final study population; 20 patients (36%) were classified as having bone metastatic disease as their final diagnosis. The patient-based diagnostic performances were (sensitivity, specificity, overall accuracy) PSMA-PET/CT (100%, 100%, 100%), NaF-PET/CT (95%, 97%, 96%) and WB-MRI (80%, 83%, 82%). The overall accuracy of PSMA-PET/CT was significantly more favourable compared to WB-MRI (p = 0.004), but not to NaF-PET/CT (p = 0.48). PSMA-PET/CT classified the number of bone metastases reliably compared to the final diagnosis (kappa coefficient 0.97) and with an “almost perfect” inter-reader agreement (kappa coefficient 0.93). Conclusions: The overall accuracy of PSMA-PET/CT was significantly more advantageous compared to WB-MRI, but not to NaF-PET/CT. Key Points: • PSMA-PET/CT assessed the presence of bone metastases correctly in all 55 patients • PSMA-PET/CT was more advantageous compared to WB-MRI • No difference was found between PSMA-PET/CT and NaF-PET/CT
AB -
Objectives: To determine the diagnostic accuracy of
68
gallium prostate-specific membrane antigen (PSMA)-based positron emission tomography/computed tomography (PET/CT) in comparison with
18
F-fluoride-based PET/CT (NaF-PET/CT) and whole-body magnetic resonance imaging (WB-MRI) for the detection of bone metastases in patients with prostate cancer. Methods: Sixty patients with prostate cancer were included in the period May 2016 to June 2017. The participants underwent three scans (index tests) within 30 days: a NaF-PET/CT, a WB-MRI and a PSMA-PET/CT. Experienced specialists assessed the scans. In the absence of a histological reference standard, the final diagnosis was determined as a panel diagnosis. Measures of the diagnostic performances of the index tests were calculated from patient-based dichotomous outcomes (0 or ≥ 1 bone metastasis) and pairwise compared (McNemar test). For each index test, the agreement with the final diagnosis with regard to the number of bone metastases detected (0, 1–5, > 5) and the inter-reader agreement was calculated (kappa coefficients). Results: Fifty-five patients constituted the final study population; 20 patients (36%) were classified as having bone metastatic disease as their final diagnosis. The patient-based diagnostic performances were (sensitivity, specificity, overall accuracy) PSMA-PET/CT (100%, 100%, 100%), NaF-PET/CT (95%, 97%, 96%) and WB-MRI (80%, 83%, 82%). The overall accuracy of PSMA-PET/CT was significantly more favourable compared to WB-MRI (p = 0.004), but not to NaF-PET/CT (p = 0.48). PSMA-PET/CT classified the number of bone metastases reliably compared to the final diagnosis (kappa coefficient 0.97) and with an “almost perfect” inter-reader agreement (kappa coefficient 0.93). Conclusions: The overall accuracy of PSMA-PET/CT was significantly more advantageous compared to WB-MRI, but not to NaF-PET/CT. Key Points: • PSMA-PET/CT assessed the presence of bone metastases correctly in all 55 patients • PSMA-PET/CT was more advantageous compared to WB-MRI • No difference was found between PSMA-PET/CT and NaF-PET/CT
KW - Bone and bones
KW - Magnetic resonance imaging
KW - Metastasis
KW - Positron emission tomography computed tomography
KW - Prostatic neoplasms
U2 - 10.1007/s00330-018-5682-x
DO - 10.1007/s00330-018-5682-x
M3 - Journal article
C2 - 30132104
AN - SCOPUS:85052604103
SN - 0938-7994
VL - 29
SP - 1221
EP - 1230
JO - European Radiology
JF - European Radiology
IS - 3
ER -
