%0 Journal Article
%T Added Value of [18F]PSMA-1007 PET/CT and PET/MRI in Patients With Biochemically Recurrent Prostate Cancer: Impact on Detection Rates and Clinical Management.
%A Abrahamsen BS
%A Tandstad T
%A Aksnessæther BY
%A Bogsrud TV
%A Castillejo M
%A Hernes E
%A Johansen H
%A Keil TMI
%A Knudtsen IS
%A Langørgen S
%A Selnæs KM
%A Bathen TF
%A Elschot M
%J J Magn Reson Imaging
%V 0
%N 0
%D 2024 Apr 28
%M 38679841
%F 5.119
%R 10.1002/jmri.29386
%X <B>BACKGROUND: </B>Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) can change management in a large fraction of patients with biochemically recurrent prostate cancer (BCR).<BR><B>OBJECTIVE: </B>To investigate the added value of PET to MRI and CT for this patient group, and to explore whether the choice of the PET paired modality (PET/MRI vs. PET/CT) impacts detection rates and clinical management.<BR><B>METHODS: </B>Retrospective.<BR><B>METHODS: </B>41 patients with BCR (median age [range]: 68 [55-78]).<BR><B>UNASSIGNED: </B>3T, including T1-weighted gradient echo (GRE), T2-weighted turbo spin echo (TSE) and dynamic contrast-enhanced GRE sequences, diffusion-weighted echo-planar imaging, and a T1-weighted TSE spine sequence. In addition to MRI, [18F]PSMA-1007 PET and low-dose CT were acquired on the same day.<BR><B>RESULTS: </B>Images were reported using a five-point Likert scale by two teams each consisting of a radiologist and a nuclear medicine physician. The radiologist performed a reading using CT and MRI data and a joint reading between radiologist and nuclear medicine physician was performed using MRI, CT, and PET from either PET/MRI or PET/CT. Findings were presented to an oncologist to create intended treatment plans. Intrareader and interreader agreement analysis was performed.<BR><B>METHODS: </B>McNemar test, Cohen's κ, and intraclass correlation coefficients. A P-value <0.05 was considered significant.<BR><B>RESULTS: </B>7 patients had positive findings on MRI and CT, 22 patients on joint reading with PET/CT, and 18 patients joint reading with PET/MRI. For overall positivity, interreader agreement was poor for MR and CT (κ = 0.36) and almost perfect with addition of PET (PET/CT κ = 0.85, PET/MRI κ = 0.85). The addition of PET from PET/CT and PET/MRI changed intended treatment in 20 and 18 patients, respectively. Between joint readings, intended treatment was different for eight patients.<BR><B>CONCLUSIONS: </B>The addition of [18F]PSMA-1007 PET/MRI or PET/CT to MRI and CT may increase detection rates, could reduce interreader variability, and may change intended treatment in half of patients with BCR.<BR><B>METHODS: </B>3 TECHNICAL EFFICACY: Stage 3.