目的:有标准化报告前列腺特异性膜抗原(PSMA)靶向正电子发射断层扫描(PET)的图像解释标准。因为高达10%的前列腺癌(PC)不表达PSMA,评估了其他靶标,例如胃泌素释放肽受体(GRPR)。GRPR靶向成像在PC分期和生化复发(BCR)中的应用一直在缓慢增加。因此,我们提出了针对GRPR靶向PET的前列腺癌分子成像标准化评估(PROMISE)标准(mPROMISE)的修改。
方法:[68Ga]Ga-RM2PET数据来自我们机构进行的最初前瞻性研究:44例患者进行了分期成像,100例患者进行了BCRPC成像。两名核医学医师根据mPROMISE标准独立评估PET。第三位专家读者作为标准参考。计算了GRPR表达式的互读可靠性,前列腺床(T),淋巴结(N),骨架(Mb),器官(Mc)转移,和扫描的最终判断。
结果:GRPRPET分期时的评分者间可靠性对GRPR表达的影响中等(0.59;95%置信区间[CI]0.40,0.78),T期相当(0.78;95%CI0.63,0.94),对于N期(0.97;95%CI0.92,1.00)和最终判断(0.92;95%CI0.82,1.00)几乎完美。BCR的互读协议显示GRPR表达(0.70;95%CI0.59,0.81)和最终判断(0.65;95%CI0.53,0.78)的基本一致,虽然在主要类别(T,N,Mb,Mc).与标准参考相比,所有子集的mPROMISE标准的性能均可接受。
结论:使用mPROMISE标准解释GRPR靶向PET显示了其可靠性,在所有主要类别中具有实质性或几乎完美的评分者之间的一致性。PROMISE标准的拟议修改将有助于临床医生降低不确定性水平,和临床试验,以实现统一的评估,reporting,GRPR靶向PET的可比性。
背景:Clinicaltrials.gov标识符:NCT03113617和NCT02624518。
There are image interpretation criteria to standardize reporting prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET). As up to 10% of prostate cancer (PC) do not express PSMA, other targets such as gastrin-releasing peptide receptor (GRPR) are evaluated. Research on GRPR-targeted imaging has been slowly increasing in usage at staging and biochemical recurrence (BCR) of PC. We therefore propose a modification of the Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria (mPROMISE) for GRPR-targeted PET.
[68 Ga]Ga-RM2 PET data from initially prospective studies performed at our institution were retrospectively reviewed: 44 patients were imaged for staging and 100 patients for BCR PC. Two nuclear medicine physicians independently evaluated PET according to the mPROMISE criteria. A third expert reader served as standard reference. Interreader reliability was computed for GRPR expression, prostate bed (T), lymph node (N), skeleton (Mb), organ (Mc) metastases, and final judgment of the scan.
The interrater reliability for GRPR PET at staging was moderate for GRPR expression (0.59; 95% confidence interval [CI] 0.40, 0.78), substantial for T-stage (0.78; 95% CI 0.63, 0.94), and almost perfect for N-stage (0.97; 95% CI 0.92, 1.00) and final judgment (0.92; 95% CI 0.82, 1.00). The interreader agreement at BCR showed substantial agreement for GRPR expression (0.70; 95% CI 0.59, 0.81) and final judgment (0.65; 95% CI 0.53, 0.78), while almost perfect agreement was seen across the major categories (T, N, Mb, Mc). Acceptable performance of the mPROMISE criteria was found for all subsets when compared to the standard reference.
Interpreting GRPR-targeted PET using the mPROMISE criteria showed its reliability with substantial or almost perfect interrater agreement across all major categories. The proposed modification of the PROMISE criteria will aid clinicians in decreasing the level of uncertainty, and clinical trials to achieve uniform evaluation, reporting, and comparability of GRPR-targeted PET.
Clinicaltrials.gov Identifier: NCT03113617 and NCT02624518.