Detection and localisation of primary prostate cancer using 68gallium prostate-specific membrane antigen positron emission tomography/computed tomography compared with multiparametric magnetic resonance imaging and radical prostatectomy specimen pathology

Arveen A. Kalapara, Tatenda Nzenza, Henry Y.C. Pan, Zita Ballok, Shakher Ramdave, Richard O'Sullivan, Andrew Ryan, Martin Cherk, Michael S. Hofman, Badrinath R. Konety, Nathan Lawrentschuk, Damien Bolton, Declan G. Murphy, Jeremy P. Grummet, Mark Frydenberg

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: To compare the accuracy of 68gallium prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) with multiparametric MRI (mpMRI) in detecting and localising primary prostate cancer when compared with radical prostatectomy (RP) specimen pathology. Patients and methods: Retrospective review of men who underwent 68Ga-PSMA PET/CT and mpMRI for primary prostate cancer before RP across four centres between 2015 and 2018. Patients undergoing imaging for recurrent disease or before non-surgical treatment were excluded. We defined pathological index tumour as the lesion with highest International Society of Urological Pathology Grade Group (GG) on RP specimen pathology. Our primary outcomes were rates of accurate detection and localisation of RP specimen pathology index tumour using 68Ga-PSMA PET/CT or mpMRI. We defined tumour detection as imaging lesion corresponding with RP specimen tumour on any imaging plane, and localisation as imaging lesion matching RP specimen index tumour in all sagittal, axial, and coronal planes. Secondary outcomes included localisation of clinically significant and transition zone (TZ) index tumours. We defined clinically significant disease as GG 3–5. We used descriptive statistics and the Mann–Whitney U-test to define and compare demographic and pathological characteristics between detected, missed and localised tumours using either imaging modality. We used the McNemar test to compare detection and localisation rates using 68Ga-PSMA PET/CT and mpMRI. Results: In all, 205 men were included in our analysis, including 133 with clinically significant disease. There was no significant difference between 68Ga-PSMA PET/CT and mpMRI in the detection of any tumour (94% vs 95%, P > 0.9). There was also no significant difference between localisation of all index tumours (91% vs 89%, P = 0.47), clinically significant index tumours (96% vs 91%, P = 0.15) or TZ tumours (85% vs 80%, P > 0.9) using 68Ga-PSMA PET/CT and mpMRI. Limitations include retrospective study design and non-central review of imaging and pathology. Conclusion: We found no significant difference in the detection or localisation of primary prostate cancer between 68Ga-PSMA PET/CT and mpMRI. Further prospective studies are required to evaluate a combined PET/MRI model in minimising tumours missed by either modality.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalBJU International
Volume126
Issue number1
DOIs
StatePublished - Jul 1 2020

Bibliographical note

Funding Information:
MSH is supported by a Clinical Fellowship Award from the Peter MacCallum Foundation. He research is also support by grants from Movember, Prostate Cancer Foundation (PCF), Prostate Cancer Foundation of Australia (PCFA) and the United States Department of Defence.

Publisher Copyright:
© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd

Keywords

  • Prostate cancer
  • metastases
  • multiparametric MRI
  • positron emission tomography
  • prostate-specific membrane antigen
  • staging

Fingerprint Dive into the research topics of 'Detection and localisation of primary prostate cancer using <sup>68</sup>gallium prostate-specific membrane antigen positron emission tomography/computed tomography compared with multiparametric magnetic resonance imaging and radical prostatectomy specimen pathology'. Together they form a unique fingerprint.

Cite this