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: a prospective diagnostic accuracy study

Eva Dyrberg; Helle W. Hendel; Tri Hien Viet Huynh; Tobias Wirenfeldt Klausen; Vibeke B. Løgager; Claus Madsen; Erik M. Pedersen; Maria Pedersen; Henrik S. Thomsen

doi:10.1007/s00330-018-5682-x

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: a prospective diagnostic accuracy study

Eva Dyrberg^*, Helle W. Hendel, Tri Hien Viet Huynh, Tobias Wirenfeldt Klausen, Vibeke B. Løgager, Claus Madsen, Erik M. Pedersen, Maria Pedersen, Henrik S. Thomsen

^*Corresponding author for this work

Department of Clinical Medicine

33 Citations (Scopus)

Abstract

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

Original language	English
Journal	European Radiology
Volume	29
Issue number	3
Pages (from-to)	1221-1230
Number of pages	10
ISSN	0938-7994
DOIs	https://doi.org/10.1007/s00330-018-5682-x
Publication status	Published - 2019

Keywords

Bone and bones
Magnetic resonance imaging
Metastasis
Positron emission tomography computed tomography
Prostatic neoplasms

UN SDGs

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

Access to Document

10.1007/s00330-018-5682-x

Cite this

Dyrberg, E., Hendel, H. W., Huynh, T. H. V., Klausen, T. W., Løgager, V. B., Madsen, C., Pedersen, E. M., Pedersen, M., & Thomsen, H. S. (2019). 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: a prospective diagnostic accuracy study. European Radiology, 29(3), 1221-1230. https://doi.org/10.1007/s00330-018-5682-x

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: a prospective diagnostic accuracy study. / Dyrberg, Eva; Hendel, Helle W.; Huynh, Tri Hien Viet et al.
In: European Radiology, Vol. 29, No. 3, 2019, p. 1221-1230.

Research output: Contribution to journal › Journal article › Research › peer-review

Dyrberg, E, Hendel, HW, Huynh, THV, Klausen, TW, Løgager, VB, Madsen, C, Pedersen, EM, Pedersen, M & Thomsen, HS 2019, '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: a prospective diagnostic accuracy study', European Radiology, vol. 29, no. 3, pp. 1221-1230. https://doi.org/10.1007/s00330-018-5682-x

Dyrberg E, Hendel HW, Huynh THV, Klausen TW, Løgager VB, Madsen C et al. 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: a prospective diagnostic accuracy study. European Radiology. 2019;29(3):1221-1230. doi: 10.1007/s00330-018-5682-x

Dyrberg, Eva ; Hendel, Helle W. ; Huynh, Tri Hien Viet et al. / 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 : a prospective diagnostic accuracy study. In: European Radiology. 2019 ; Vol. 29, No. 3. pp. 1221-1230.

@article{40988c70f24c4383959f09b7cd898622,

title = "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: a prospective diagnostic accuracy study",

abstract = " 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 ",

keywords = "Bone and bones, Magnetic resonance imaging, Metastasis, Positron emission tomography computed tomography, Prostatic neoplasms",

author = "Eva Dyrberg and Hendel, {Helle W.} and Huynh, {Tri Hien Viet} and Klausen, {Tobias Wirenfeldt} and L{\o}gager, {Vibeke B.} and Claus Madsen and Pedersen, {Erik M.} and Maria Pedersen and Thomsen, {Henrik S.}",

year = "2019",

doi = "10.1007/s00330-018-5682-x",

language = "English",

volume = "29",

pages = "1221--1230",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer",

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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

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ER -