title: Improved performance of SPECT-CT In-111 capromab pendetide by correlation with diffusion-weighted magnetic resonance imaging for identifying metastatic pelvic lymphadenopathy in prostate cancer.
abstract: OBJECTIVE
  To preliminarily evaluate the potential for an improvement in diagnostic performance by a combined interpretation of In-111 capromab pendetide single photon emission computed tomography (SPECT) including computed tomography (CT) image fusion with magnetic resonance diffusion-weighted imaging (MR-DWI) for identifying prostate cancer in pelvic lymph nodes thru correlation with histopathology.
  
  
  METHODS
  This institutional approved, retrospective study identified patients with available histopathology of lymph nodes removed at the time of radical prostatectomy and who had undergone staging with In-111 capromab pendetide SPECT-CT and/or pelvic MRI (including DWI). The performance of In-111 capromab pendetide SPECT for identifying malignant lymph nodes was assessed. Subsequently, a combined reading of In-111 capromab pendetide SPECT and prostate MRI with DWI was performed and the performance assessed.
  
  
  RESULTS
  18 patients underwent In-111 capromab pendetide SPECT-CT. Of these, 12 patients had also undergone imaging with MR-DWI. In-111 capromab pendetide SPECT-CT had a sensitivity of 40.0% and specificity of 96.7% for identification of malignant lymph nodes. However, In-111 capromab pendetide SPECT-CT combined with MRI with DWI had a sensitivity of 88.9% and specificity of 98.5%.
  
  
  CONCLUSIONS
  The addition of MR-DWI to the interpretation of In-111 capromab pendetide SPECT-CT may increase the sensitivity for detecting malignant lymph nodes in prostate cancer. Future prospective evaluation of combined In-111 capromab pendetide SPECT-CT and MR-DWI is indicated and may improve clinical evaluation of nodal disease in prostate cancer.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA, andrewdhardie@gmail.com.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hardie
authors.forename: William J
authors.initials: WJ
authors.lastname: Rieter
authors.forename: Marques L
authors.initials: ML
authors.lastname: Bradshaw
authors.forename: Leonie L
authors.initials: LL
authors.lastname: Gordon
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Young
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Keane
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007205:Indium Radioisotopes; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000556:secondary; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000911:Antibodies, Monoclonal; D007205:Indium Radioisotopes; C101315:Capromab Pendetide