PD32-07 PREOPERATIVE LYMPH NODE STAGING IN INTERMEDIATE TO HIGH-RISK PROSTATE CANCER PATIENTS USING 68GA-HBED-PSMA PET HYBRID IMAGING – A PATIENT- AND FIELD-BASED ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2015PD32-07 PREOPERATIVE LYMPH NODE STAGING IN INTERMEDIATE TO HIGH-RISK PROSTATE CANCER PATIENTS USING 68GA-HBED-PSMA PET HYBRID IMAGING – A PATIENT- AND FIELD-BASED ANALYSIS Tobias Maurer, Lisa Pähr, Michael Souvatzoglou, Gregor Weirich, Hubert Kübler, Hans-Jürgen Wester, Bernhard Haller, Markus Schwaiger, Jürgen Erich Gschwend, and Matthias Eiber Tobias MaurerTobias Maurer More articles by this author , Lisa PährLisa Pähr More articles by this author , Michael SouvatzoglouMichael Souvatzoglou More articles by this author , Gregor WeirichGregor Weirich More articles by this author , Hubert KüblerHubert Kübler More articles by this author , Hans-Jürgen WesterHans-Jürgen Wester More articles by this author , Bernhard HallerBernhard Haller More articles by this author , Markus SchwaigerMarkus Schwaiger More articles by this author , Jürgen Erich GschwendJürgen Erich Gschwend More articles by this author , and Matthias EiberMatthias Eiber More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2118AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently, Glu-NH-CO-NH-Lys-(Ahx)-[(68)Ga(HBED-CC)] as a novel 68Gallium-labelled ligand of the prostate-specific membrane antigen (68Ga-HBED-PSMA) has been introduced for the diagnostic evaluation of prostate cancer (PCa) patients. The aim of this study was to evaluate the accuracy of preoperative 68Ga-HBED-PSMA PET with the results of postoperative histological findings after radical prostatectomy (RP) and pelvine template lymph node (LN) dissection with regard to metastatic LN involvement. METHODS 92 consecutive patients with intermediate to high-risk PCa patients were included. All patients received 68Ga-HBED-PSMA PET hybrid imaging prior to surgery. Pelvine template LN dissection was performed according to 8 predefined anatomical fields. In all patients LN involvement was evaluated in a blinded fashion according to a 5-point scale (1 = metastatic; 2 = probably metastatic; 3 = equivocal; 4 = probably benign; 5 = benign) on a patient- and field-based manner and correlated to postoperative histological analysis. RESULTS Due to lacking PSMA expression of the primary tumor 4 patients were excluded from further analysis. In total, 20 patients showed metastatic LN. 68Ga-HBED-PSMA PET detected 15 out of 20 patients with histological proven metastatic LN (sensitivity: 75.0%) and correctly classified all 68 patients without histological evidence of LN metastases (specificity: 100%; accuracy 94.3%; PPV: 100%; NPV: 93.2%). 5 patients without evidence of metastatic LN on imaging showed only small metastases in single LN (3 patients with one positive LN, 2 patients with two LN). In total, 470 anatomical fields could be analysed (52 with LN metastases). Sensitivity, specificity, accuracy, PPV and NPV for the field-based analysis were calculated as 73.1%, 98.6%, 95.7%, 86.4% and 96.7%, respectively. CONCLUSIONS 68Ga-HBED-PSMA PET hybrid imaging shows a high sensitivity as well as superb specificity and accuracy for lymph node staging in intermediate to high-risk PCa patients and might replace current standard imaging (sole MRI, CT or PET using FDG or choline-based tracers) in the future. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e707 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tobias Maurer More articles by this author Lisa Pähr More articles by this author Michael Souvatzoglou More articles by this author Gregor Weirich More articles by this author Hubert Kübler More articles by this author Hans-Jürgen Wester More articles by this author Bernhard Haller More articles by this author Markus Schwaiger More articles by this author Jürgen Erich Gschwend More articles by this author Matthias Eiber More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...