Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference
Abstract Background Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extrapr...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-01-01
|
| Series: | EJNMMI Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41824-024-00234-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559918164836352 |
|---|---|
| author | Erland Hvittfeldt Fredrik Hedeer Erik Thimansson Kevin Sandeman David Minarik Jacob Ingvar Anders Bjartell Elin Trägårdh |
| author_facet | Erland Hvittfeldt Fredrik Hedeer Erik Thimansson Kevin Sandeman David Minarik Jacob Ingvar Anders Bjartell Elin Trägårdh |
| author_sort | Erland Hvittfeldt |
| collection | DOAJ |
| description | Abstract Background Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). Previous studies have shown high heterogeneity in methods and results. Our aim was to compare [18F]PSMA-1007 PET/CT to magnetic resonance imaging (MRI) in evaluation of EPE and SVI, building on a previously described method for standardized evaluation. We retrospectively included 124 patients who had undergone MRI, PSMA PET/CT and prostatectomy. PSMA PET/CT images were evaluated by two nuclear medicine physicians. Using a standardized method, they measured length of capsular contact (LCC) and assessed EPE and SVI visually with the use of 5-point Likert scales. A radiologist evaluated MRI images using criteria based on Prostate Imaging–Reporting and Data System version and incorporating LCC measurement and Likert scales. We evaluated diagnostic performance with histopathology as reference, and the interrater reliability of the PET evaluations. Results The sensitivity and specificity for detecting EPE with the quantitative LCC method for PSMA PET/CT was 0.46/0.91, for the visual method 0.28/0.82 and for the combination of the two 0.54/0.76. AUC in ROC analysis for the LCC method was 0.70. For MRI the sensitivity and specificity were 0.80/0.64. For SVI, PET/CT and MRI had sensitivity and specificity of 0.14/1.0 and 0.50/0.92 respectively. The intraclass correlation coefficient for the PET LCC measurement was 0.68, the kappa values for the visual Likert scales for PET were 0.53 for EPE and 0.63 for SVI. Conclusions In this study, we attempted to standardize quantitative and qualitative PSMA PET/CT evaluation of EPE and SVI and compare the method with MRI. MRI had a higher sensitivity for EPE while PSMA had a higher specificity. For SVI, both methods had high specificity. The interrater reliability for the PSMA PET/CT evaluations was moderate to substantial. |
| format | Article |
| id | doaj-art-d669aa3e503f4b648d2aff625d41cee5 |
| institution | Kabale University |
| issn | 3005-074X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Springer |
| record_format | Article |
| series | EJNMMI Reports |
| spelling | doaj-art-d669aa3e503f4b648d2aff625d41cee52025-01-05T12:05:06ZengSpringerEJNMMI Reports3005-074X2025-01-019111310.1186/s41824-024-00234-4Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as referenceErland Hvittfeldt0Fredrik Hedeer1Erik Thimansson2Kevin Sandeman3David Minarik4Jacob Ingvar5Anders Bjartell6Elin Trägårdh7Department of Translational Medicine, Lund UniversityDepartment of Translational Medicine, Lund UniversityDepartment of Translational Medicine, Lund UniversityDepartment of Pathology, Region SkåneDepartment of Translational Medicine, Lund UniversityDepartment of Translational Medicine, Lund UniversityDepartment of Translational Medicine, Lund UniversityDepartment of Translational Medicine, Lund UniversityAbstract Background Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). Previous studies have shown high heterogeneity in methods and results. Our aim was to compare [18F]PSMA-1007 PET/CT to magnetic resonance imaging (MRI) in evaluation of EPE and SVI, building on a previously described method for standardized evaluation. We retrospectively included 124 patients who had undergone MRI, PSMA PET/CT and prostatectomy. PSMA PET/CT images were evaluated by two nuclear medicine physicians. Using a standardized method, they measured length of capsular contact (LCC) and assessed EPE and SVI visually with the use of 5-point Likert scales. A radiologist evaluated MRI images using criteria based on Prostate Imaging–Reporting and Data System version and incorporating LCC measurement and Likert scales. We evaluated diagnostic performance with histopathology as reference, and the interrater reliability of the PET evaluations. Results The sensitivity and specificity for detecting EPE with the quantitative LCC method for PSMA PET/CT was 0.46/0.91, for the visual method 0.28/0.82 and for the combination of the two 0.54/0.76. AUC in ROC analysis for the LCC method was 0.70. For MRI the sensitivity and specificity were 0.80/0.64. For SVI, PET/CT and MRI had sensitivity and specificity of 0.14/1.0 and 0.50/0.92 respectively. The intraclass correlation coefficient for the PET LCC measurement was 0.68, the kappa values for the visual Likert scales for PET were 0.53 for EPE and 0.63 for SVI. Conclusions In this study, we attempted to standardize quantitative and qualitative PSMA PET/CT evaluation of EPE and SVI and compare the method with MRI. MRI had a higher sensitivity for EPE while PSMA had a higher specificity. For SVI, both methods had high specificity. The interrater reliability for the PSMA PET/CT evaluations was moderate to substantial.https://doi.org/10.1186/s41824-024-00234-4PSMA PET/CTMRIProstate cancerT staging |
| spellingShingle | Erland Hvittfeldt Fredrik Hedeer Erik Thimansson Kevin Sandeman David Minarik Jacob Ingvar Anders Bjartell Elin Trägårdh Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference EJNMMI Reports PSMA PET/CT MRI Prostate cancer T staging |
| title | Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference |
| title_full | Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference |
| title_fullStr | Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference |
| title_full_unstemmed | Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference |
| title_short | Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [18F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference |
| title_sort | semi standardized evaluation of extraprostatic extension and seminal vesicle invasion with 18f psma 1007 pet ct a comparison to mri using histopathology as reference |
| topic | PSMA PET/CT MRI Prostate cancer T staging |
| url | https://doi.org/10.1186/s41824-024-00234-4 |
| work_keys_str_mv | AT erlandhvittfeldt semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT fredrikhedeer semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT erikthimansson semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT kevinsandeman semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT davidminarik semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT jacobingvar semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT andersbjartell semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference AT elintragardh semistandardizedevaluationofextraprostaticextensionandseminalvesicleinvasionwith18fpsma1007petctacomparisontomriusinghistopathologyasreference |