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dc.contributor.authorDonato, Peter
dc.contributor.authorRoberts, Matthew J
dc.contributor.authorMorton, Andrew
dc.contributor.authorKyle, Samuel
dc.contributor.authorCoughlin, Geoff
dc.contributor.authorEsler, Rachel
dc.contributor.authorDunglison, Nigel
dc.contributor.authorGardiner, Robert A
dc.contributor.authorYaxley, John
dc.date.accessioned2020-02-24T03:53:42Z
dc.date.available2020-02-24T03:53:42Z
dc.date.issued2019
dc.identifier.issn1619-7070
dc.identifier.doi10.1007/s00259-018-4160-7
dc.identifier.urihttp://hdl.handle.net/10072/391823
dc.description.abstractPURPOSE: Positron emission tomography (PET) for prostate-specific membrane antigen (PSMA) represents a promising method for prostate cancer diagnosis and staging. Comparisons of PSMA-based tumour characterisation to multiparametric MRI (mpMRI) are limited, hence this study sought to compare the diagnostic accuracy of 68Ga-PSMA PET/CT to mpMRI against radical prostatectomy (RP) whole gland histopathology. METHODS: A retrospective cohort study of consecutive patients who underwent pre-operative mpMRI and 68Ga-PSMA PET/CT followed by a RP was performed. Standard clinical parameters were collected. "Per patient" and "per lesion" analyses for image-based detection according to RP histopathology were described using sensitivity, specificity and other measures of diagnostic accuracy. RESULTS: Fifty-eight patients (median age 65.5 years, median PSA 7.35 ng/mL) underwent RP, resulting in a high-risk cohort (≥pT3 69%). Sensitivities for identification of index lesion, bilateral and multifocal disease were 90%, 21%, 19% for mpMRI and 93%, 42%, 34% for 68Ga-PSMA PET/CT. Histology analyses revealed 88 cancer foci of Gleason grades 3 + 3 (4%), 3 + 4 (64%), 4 + 3 (19%), 4 + 4 (3%) and ≥ 4 + 5 (10%), of which 68Ga-PSMA PET/CT correctly detected more foci (78%, AUC 0.817) than mpMRI (69%, AUC 0.729). CONCLUSIONS: 68Ga-PSMA PET/CT may better reflect RP histopathology compared to mpMRI when considering multifocal and bilateral disease. These findings may influence surgical planning, targeted biopsy and focal therapy strategies and require further research.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofpagefrom20
dc.relation.ispartofpageto30
dc.relation.ispartofissue1
dc.relation.ispartofjournalEuropean Journal of Nuclear Medicine and Molecular Imaging
dc.relation.ispartofvolume46
dc.subject.fieldofresearchOther physical sciences
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode5199
dc.subject.fieldofresearchcode3202
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsRadiology, Nuclear Medicine & Medical Imaging
dc.subject.keywordsProstatic neoplasms
dc.subject.keywordsPositron-emission tomography
dc.titleImproved specificity with Ga-68 PSMA PET/CT to detect clinically significant lesions "invisible" on multiparametric MRI of the prostate: a single institution comparative analysis with radical prostatectomy histology
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationDonato, P; Roberts, MJ; Morton, A; Kyle, S; Coughlin, G; Esler, R; Dunglison, N; Gardiner, RA; Yaxley, J, Improved specificity with Ga-68 PSMA PET/CT to detect clinically significant lesions "invisible" on multiparametric MRI of the prostate: a single institution comparative analysis with radical prostatectomy histology, European Journal of Nuclear Medicine and Molecular Imaging , 2019, 46 (1), pp. 20-30
dcterms.dateAccepted2018-09-05
dc.date.updated2020-02-24T03:52:26Z
gro.hasfulltextNo Full Text
gro.griffith.authorGardiner, Robert A.


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