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[18F]Flotufolastat PET/MRI in Patients with Suspected Prostate Cancer: Correlation with Histopathologic Biopsy Results
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DOI：10.2967/jnumed.125.270435.png)
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Abstract
En 中文
This retrospective analysis investigated the detection accuracy of [F-18]flotufolastat 18 F]flotufolastat ([F-18]rhPSMA-7.3) 18 F]rhPSMA-7.3) PET/MRI in patients with sus- pected prostate cancer (PCa), read using the PRIMARY score. Perfor- mance was compared with that of multiparametric MRI (mpMRI) assessed per Prostate Imaging Reporting , Data System (PI-RADS) criteria. Methods: [F-18]flotufolastat F-18]flotufolastat PET and mpMRI scans of the prostate were read independently using PRIMARY and PI-RADS scores, respectively. Imaging data were analyzed per patient and by prostate gland sextant , scores were compared with transrectal histopathologic biopsy results (clinically significant PCa: International Society of Urological Pathology grade >= 2). Diagnostic performance parameters (sensitivity, specificity, and positive and negative predic- tive values) were calculated; receiver-operating characteristic analy- ses with 95% CI were performed per patient and by sextant to compare the detection accuracy of [F-18]flotufolastat 18 F]flotufolastat PET, mpMRI, and combined PET/MRI. Results: Data from 72 patients (median prescan prostate-specific antigen level, 10.1 ng/mL) were reviewed. Twenty patients had histopathologically confirmed, clinically significant PCa, versus 27 by PRIMARY criteria (score, 3-5) and 43 by PI-RADS criteria (score, 3-5). Patient-level sensitivity, specificity, and positive and neg- ative predictive values were, respectively, 85%, 81%, 63%, and 93% for [F-18]flotufolastat 18 F]flotufolastat PET versus 85%, 50%, 40%, and 90% for mpMRI and 95%, 42%, 39%, and 96% for PET/MRI combined. Sextant-level sensitivity, specificity, and positive and negative predictive values were, respectively, 63%, 93%, 53%, and 95% for [F-18]flotufolastat 18 F]flotufolastat PET versus 45%, 88%, 33%, and 92% for mpMRI and 69%, 83%, 35%, and 95% for PET/MRI combined. For both patient- and sextant- level receiver-operating characteristic analysis, comparisons of area under the curve for [F-18]flotufolastat/PRIMARY 18 F]flotufolastat/PRIMARY score (0.88 [95% CI, 0.79-0.97]) versus mpMRI/PI-RADS score (0.75 [95% CI, 0.62-0.87) and combined PET/MRI (0.82 [95% CI, 0.72-0.92]) did not reach sta- tistical significance (all P > 0.05). Conclusion: The PRIMARY score was easily adopted for [F-18]flotufolastat 18 F]flotufolastat PET, which outperformed mpMRI (read using PI-RADS) for the detection of histopathologically confirmed PCa. Although combined PET/MRI showed the highest sensitivity, specificity was lower than for PET or MRI alone.
Keywords:
[(1)8F]flotufolastat
mpMRI
PET/MRI
PRIMARY score
PSMA PET
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