title: Integrated68Ga-HBED-CC-PSMA-PET/MRI in patients with suspected recurrent prostate cancer.
abstract: OBJECTIVE
  Evaluate the diagnostic accuracy of68Ga-labeled HBED-CC-PSMA-PET/MRI for detection of recurrent PCa in comparison to PET/CT.
  
  
  METHODS
  48 patients with suspected recurrent PCa underwent PET/CT after injection of the68Ga-HBED-CC-PSMA ligand followed by integrated PET/MRI. Image analysis was performed by nuclear medicine physicians and radiologists with respect to the detection of lymph node metastases, bone metastases and local recurrence of the tumour. Image quality was evaluated visually based on a three-point ordinal scale.
  
  
  RESULTS
  From 48 patients initially examined, 25 were finally eligible for qualitative and quantitative image evaluation. In 14 patients, neither PET/CT nor PET/MRI found tumour lesions, and 9 patients were excluded from image analysis due to a pronounced extinction artifact around the urinary bladder (halo). In comparison to68Ga-HBED-CC-PSMA-PET/CT,68Ga-HBED-CC-PSMA-PET/MRI identified 14 vs. 9 local recurrences in the prostate bed and 23 vs. 20 PET-positive lymph nodes, and 4 vs. 4 PET-positive bone lesions, respectively. While the improved detection of suspicious lymph nodes was primarily attributable to the PET component, the advantageous detection of tumour recurrences in the prostate bed was chiefly referable to the superior soft-tissue contrast of the MR component of integrated PET/MRI. Analysis of SUVmaxrevealed that68Ga-HBED-CC-PSMA-PET/MRI provided significantly higher SUVmaxcompared to68Ga-HBED-CC-PSMA-PET/CT (17.6, range 2.0-49.6, and 15.1, range 3.5-36.8, respectively, p = 0.0019).
  
  
  CONCLUSIONS
  68Ga-HBED-CC-PSMA-PET/MRI was found to be superior as compared to68Ga-HBED-CC-PSMA-PET/CT in the detection of PSMA-expressing prostate bed recurrences.
authors.affiliation: Susanne Lütje, PhD, resident Nuclear Medicine, University Medical Center Essen, Clinic for Nuclear Medicine, Hufelandstraße 55, 45122 Essen, Germany, Tel: +49 201 - 723 83663, E-Mail: Susanne.Luetje@uk-essen.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Lütje
authors.forename: Joseph
authors.initials: J
authors.lastname: Cohnen
authors.forename: Benedikt
authors.initials: B
authors.lastname: Gomez
authors.forename: Johannes
authors.initials: J
authors.lastname: Grüneisen
authors.forename: Lino
authors.initials: L
authors.lastname: Sawicki
authors.forename: Herbert
authors.initials: H
authors.lastname: Rübben
authors.forename: Andreas
authors.initials: A
authors.lastname: Bockisch
authors.forename: Lale
authors.initials: L
authors.lastname: Umutlu
authors.forename: Thorsten D
authors.initials: TD
authors.lastname: Pöppel
authors.forename: Axel
authors.initials: A
authors.lastname: Wetter
mesh_terms: D000368:Aged; D000954:Antigens, Surface; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives*; D043425:Glutamate Carboxypeptidase II / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000954:Antigens, Surface; D003287:Contrast Media; D019275:Radiopharmaceuticals; 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: PET/CT; PET/MRI; PSMA; prostate cancer