Nuklearmedizin 2019; 58(02): 138
DOI: 10.1055/s-0039-1683570
Vorträge
PET: Prostata-Karzinom
Georg Thieme Verlag KG Stuttgart · New York

Diagnostic Efficacy of 18F-rhPSMA7 PET imaging for N-staging in 58 Consecutive Patients with High Risk Prostate Cancer compared to histopathology

M Krönke
1   Klinikum rechts der Isar, Klinik und Poliklinik für Nuklearmedizin, München
,
A Wurzer
2   Technische Universität München, Lehrstuhl für Radiopharmazie, München
,
K Schwamborn
3   Klinikum rechts der Isar, Institut für Pathologie, München
,
L Ulbricht
1   Klinikum rechts der Isar, Klinik und Poliklinik für Nuklearmedizin, München
,
L Jooß
1   Klinikum rechts der Isar, Klinik und Poliklinik für Nuklearmedizin, München
,
T Maurer
4   Universitätsklinikum Hamburg-Eppendorf, Martini-Klinik, Hamburg
,
T Horn
5   Klinikum rechts der Isar, Klinik und Poliklinik für Urologie, München
,
B Haller
6   Klinikum rechts der Isar, Institut für medizinische Statistik und Epidemiologie, München
,
HJ Wester
2   Technische Universität München, Lehrstuhl für Radiopharmazie, München
,
W Weber
1   Klinikum rechts der Isar, Klinik und Poliklinik für Nuklearmedizin, München
,
M Eiber
1   Klinikum rechts der Isar, Klinik und Poliklinik für Nuklearmedizin, München
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Publikationsverlauf

Publikationsdatum:
27. März 2019 (online)

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    Ziel/Aim:

    18F-rhPSMA7 is a new PSMA -targeting agent which can be efficiently labeled with Flour-18 and radiometals. In addition, it only shows minimal renal excretion. This retrospective analysis investigates the efficacy of 18F-rhPSMA7 PET for primary N-staging compared morphological imaging and validated by histopathology.

    Methodik/Methods:

    58 consecutive patients (median PSA 12.4 ng/ml, range: 1.2 – 81.6) with high risk prostate cancer (defined by D'Amico) staged with 18F-rhPSMA7 PET/CT or PET/MRI between July 2017 and June 2018 were included. All patients underwent subsequent radical prostatectomy and extended pelvic lymph node dissection. Median injected activity was 327MBq (Range: 132 – 410MBq), median uptake time 79.5 min (range: 60 – 153 min). The presence of lymph node metastases was rated by one experienced reader independently for both the PET- and morphological dataset on template base using a 5-point scale. Results were compared to histopathological findings on patient and template base.

    Ergebnisse/Results:

    Lymph node metastases were present in 18 patients (31.0%) located in 54 of 371 templates (14.6%). On patient-based analysis the sensitivity, specificity and accuracy of 18F-rhPSMA7-PET were 72.2%, 92.5% and 86.2%, and those of morphological imaging 50.0%, 72.5% and 65.5%, respectively. On template-based analysis the sensitivity, specificity and accuracy of 18F-rhPSMA7-PET were 51.9%, 96.6% and 91.4%, and those of morphological imaging 11.1%, 95.3% and 84.1%, respectively. On ROC analyses 18F-rhPSMA7-PET performed significantly better than morphological imaging on patient and template-based analyses (AUCs of 0.858 vs. 0.649, p = 0.012 and 0.753 vs. 0.594, p = 0.035, respectively).

    Schlussfolgerungen/Conclusions:

    18F-rhPSMA7 PET imaging is superior to morphological imaging for N-staging of primary high risk prostate cancer. The efficacy of 18F-rhPSMA7 is similar to published data for 68Ga-PSMA11.


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