title: (68)Ga-HBED-CC-PSMA PET/CT Versus Histopathology in Primary Localized Prostate Cancer: A Voxel-Wise Comparison.
abstract: We performed a voxel-wise comparison of (68)Ga-HBED-CC-PSMA PET/CT with prostate histopathology to evaluate the performance of (68)Ga-HBED-CC-PSMA for the detection and delineation of primary prostate cancer (PCa).
  
  
  
  Nine patients with histopathological proven primary PCa underwent (68)Ga-HBED-CC-PSMA PET/CT followed by radical prostatectomy. Resected prostates were scanned by ex-vivo CT in a special localizer and histopathologically prepared. Histopathological information was matched to ex-vivo CT. PCa volume (PCa-histo) and non-PCa tissue in the prostate (NPCa-histo) were processed to obtain a PCa-model, which was adjusted to PET-resolution (histo-PET). Each histo-PET was coregistered to in-vivo PSMA-PET/CT data.
  
  
  
  Analysis of spatial overlap between histo-PET and PSMA PET revealed highly significant correlations (p < 10(-5)) in nine patients and moderate to high coefficients of determination (R²) from 42 to 82 % with an average of 60 ± 14 % in eight patients (in one patient R(2) = 7 %). Mean SUVmean in PCa-histo and NPCa-histo was 5.6 ± 6.1 and 3.3 ± 2.5 (p = 0.012). Voxel-wise receiver-operating characteristic (ROC) analyses comparing the prediction by PSMA-PET with the non-smoothed tumor distribution from histopathology yielded an average area under the curve of 0.83 ± 0.12. Absolute and relative SUV (normalized to SUVmax) thresholds for achieving at least 90 % sensitivity were 3.19 ± 3.35 and 0.28 ± 0.09, respectively.
  
  
  
  Voxel-wise analyses revealed good correlations of (68)Ga-HBED-CC-PSMA PET/CT and histopathology in eight out of nine patients. Thus, PSMA-PET allows a reliable detection and delineation of PCa as basis for PET-guided focal therapies.
authors.affiliation: Department of Radiation Oncology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Constantinos
authors.initials: C
authors.lastname: Zamboglou
authors.affiliation: Department of Nuclear Medicine, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Florian
authors.initials: F
authors.lastname: Schiller
authors.affiliation: Department of Radiation Oncology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Tobias
authors.initials: T
authors.lastname: Fechter
authors.affiliation: Department of Nuclear Medicine, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Gesche
authors.initials: G
authors.lastname: Wieser
authors.affiliation: Department of Urology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Cordula Annette
authors.initials: CA
authors.lastname: Jilg
authors.affiliation: Department of Nuclear Medicine, Claraspital Basel, Switzerland;
authors.forename: Alin
authors.initials: A
authors.lastname: Chirindel
authors.affiliation: Department of Radiation Oncology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Nasr
authors.initials: N
authors.lastname: Salman
authors.affiliation: Department of Pathology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Drendel
authors.affiliation: Department of Pathology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.affiliation: Department of Nuclear Medicine, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Michael
authors.initials: M
authors.lastname: Mix
authors.affiliation: Department of Nuclear Medicine, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Philipp Tobias
authors.initials: PT
authors.lastname: Meyer
authors.affiliation: Department of Radiation Oncology, University Medical Center Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany;
authors.forename: Anca Ligia
authors.initials: AL
authors.lastname: Grosu
mesh_terms: D000954:Antigens, Surface / Q000008:administration & dosage; D004492:Edetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D043425:Glutamate Carboxypeptidase II / Q000008:administration & dosage; D006651:Histocytochemistry / Q000379:methods*; D006801:Humans; D008297:Male; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011868:Radioisotopes / Q000008:administration & dosage
chemical_list: D000954:Antigens, Surface; D011868:Radioisotopes; C075313:N,N'-bis(2-hydroxy-5-(ethylene-beta-carboxy)benzyl)ethylenediamine N,N'-diacetic acid; D004492:Edetic Acid; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II
keywords: PSMA PET/CT; Prostate cancer; SUV.; histopathology; voxel-wise