title: 68Ga-PSMA Positron Emission Tomography/Computed Tomography Provides Accurate Staging of Lymph Node Regions Prior to Lymph Node Dissection in Patients with Prostate Cancer.
abstract: We evaluated the accuracy of68Ga-prostate-specific membrane antigen-HBED-CC (68Ga-PSMA) positron emission tomography/computed tomography (PET/CT) for nodal staging prior to lymph node dissection (LND) in patients with prostate cancer (PCa). Thirty-four patients with histologically proven PCa underwent68Ga-PSMA-HBED-CC PET/CT prior to radical prostatectomy with primary LND (pLND; n=20) and PET/CT prior to secondary LND (sLND; n=14). Accuracy of PET and CT were analysed separately for staging of the following 71 lymph node (LN) regions: pelvic left (n=30), pelvic right (n=31), presacral (n=3), and para-aortic (n=7). Postoperative histopathology was taken as a reference standard. Thirty-seven of 71 (52%) regions showed LN metastases on histopathology. Sensitivity, specificity, positive predictive value, and negative predictive value for detection of LN metastases were 84%, 82%, 84%, and 82% for PET criteria and 65%, 76%, 75%, and 67% for CT criteria. PET was more accurate for nodal staging compared with CT both at pLND (88% vs 75%) and sLND (77% vs 65%). Overall,68Ga-PSMA PET/CT provides accurate nodal staging prior to pLND and sLND for PCa. PATIENT SUMMARY:68Ga-PSMA positron emission tomography/computed tomography is accurate in detecting tumour spread to lymph nodes before patients undergo surgery for prostate cancer.
authors.affiliation: Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Herlemann
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Wenter
authors.affiliation: Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kretschmer
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Kolja M
authors.initials: KM
authors.lastname: Thierfelder
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany; Comprehensive Cancer Centre, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.affiliation: Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Claudius
authors.initials: C
authors.lastname: Faber
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Gildehaus
authors.affiliation: Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany; Comprehensive Cancer Centre, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.affiliation: Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany; Comprehensive Cancer Centre, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany. Electronic address: wolfgang.fendler@med.uni-muenchen.de.
authors.forename: Wolfgang P
authors.initials: WP
authors.lastname: Fendler
mesh_terms: D000954:Antigens, Surface; D001011:Aorta; D005710:Gallium Radioisotopes; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D010388:Pelvis; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology*; D019275:Radiopharmaceuticals; D012447:Sacrum
chemical_list: D000954:Antigens, Surface; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II
keywords: Lymph node dissection; PET/CT; PSMA; Positron emission tomography; Prostate cancer