背景:前列腺特异性膜抗原(PSMA)正电子发射断层扫描(PET)可以改变大部分生化复发性前列腺癌(BCR)患者的治疗。
目的:探讨PET对该患者组MRI和CT的附加价值,并探讨PET配对模式的选择(PET/MRI与PET/CT)影响检出率和临床管理。
方法:回顾性。
方法:41例BCR患者(中位年龄[范围]:68[55-78])。
■3T,包括T1加权梯度回波(GRE),T2加权涡轮自旋回波(TSE)和动态对比增强GRE序列,扩散加权回波平面成像,和T1加权的TSE脊柱序列。除了MRI,在同一天获得[18F]PSMA-1007PET和低剂量CT。
结果:由两个由放射科医师和核医学医师组成的小组使用5点Likert量表报告图像。放射科医生使用CT和MRI数据进行读数,放射科医生和核医学医师之间的联合读数使用MRI进行,CT,和PET/MRI或PET/CT。将研究结果提交给肿瘤学家,以制定预期的治疗计划。进行了内部和内部读者协议分析。
方法:McNemar试验,科恩κ,和类内相关系数。P值<0.05被认为是显著的。
结果:7例患者的MRI和CT检查结果为阳性,22例患者进行PET/CT联合阅读,18例患者进行PET/MRI联合阅读。对于总体积极性,MR和CT的阅读器一致性较差(κ=0.36),添加PET后几乎完美(PET/CTκ=0.85,PET/MRIκ=0.85)。PET/CT和PET/MRI的增加改变了20和18例患者的预期治疗,分别。在关节读数之间,8例患者的预期治疗不同.
结论:在MRI和CT中添加[18F]PSMA-1007PET/MRI或PET/CT可能会提高检出率,可以减少内部阅读器的可变性,并可能改变一半BCR患者的预期治疗。
方法:3技术效果:第3阶段。
BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) can change management in a large fraction of patients with biochemically recurrent prostate cancer (BCR).
OBJECTIVE: 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.
METHODS: Retrospective.
METHODS: 41 patients with BCR (median age [range]: 68 [55-78]).
UNASSIGNED: 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.
RESULTS: 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.
METHODS: McNemar test, Cohen\'s κ, and intraclass correlation coefficients. A P-value <0.05 was considered significant.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 3 TECHNICAL EFFICACY: Stage 3.