18 F-Choline PET/mpMRI for Detection of Clinically Significant Prostate Cancer: Part 1. Improved Risk Stratification for MRI-Guided Transrectal Prostate Biopsies
A prospective single-arm clinical trial was conducted to determine whether F-choline PET/mpMRI can improve the specificity of multiparametric MRI (mpMRI) of the prostate for Gleason ≥ 3+4 prostate cancer. Before targeted and systematic prostate biopsy, mpMRI and F-choline PET/CT were performed on 56...
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| Vydané v: | The Journal of nuclear medicine (1978) Ročník 61; číslo 3; s. 337 |
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| Hlavní autori: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.03.2020
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| ISSN: | 1535-5667 |
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| Abstract | A prospective single-arm clinical trial was conducted to determine whether
F-choline PET/mpMRI can improve the specificity of multiparametric MRI (mpMRI) of the prostate for Gleason ≥ 3+4 prostate cancer.
Before targeted and systematic prostate biopsy, mpMRI and
F-choline PET/CT were performed on 56 evaluable subjects with 90 Likert score 3-5 mpMRI target lesions, using a
F-choline target-to-background ratio of greater than 1.58 to indicate a positive
F-choline result. Prostate biopsies were performed after registration of real-time transrectal ultrasound with T2-weighted MRI. A mixed-effects logistic regression was applied to measure the performance of mpMRI (based on prospective Likert and retrospective Prostate Imaging Reporting and Data System, version 2 [PI-RADS], scores) compared with
F-choline PET/mpMRI to detect Gleason ≥ 3+4 cancer.
The per-lesion accuracy of systematic plus targeted biopsy for mpMRI alone was 67.8% (area under receiver-operating-characteristic curve [AUC], 0.73) for Likert 4-5 and 70.0% (AUC, 0.76) for PI-RADS 3-5. Several PET/MRI models incorporating
F-choline with mpMRI data were investigated. The most promising model selected all high-risk disease on mpMRI (Likert 5 or PI-RADS 5) plus low- and intermediate-risk disease (Likert 4 or PI-RADS 3-4), with an elevated
F-choline target-to-background ratio greater than 1.58 as positive for significant cancer. Using this approach, the accuracy on a per-lesion basis significantly improved to 88.9% for Likert (AUC, 0.90;
< 0.001) and 91.1% for PI-RADS (AUC, 0.92;
< 0.001). On a per-patient basis, the accuracy improved to 92.9% for Likert (AUC, 0.93;
< 0.001) and to 91.1% for PI-RADS (AUC, 0.91;
= 0.009).
F-choline PET/mpMRI improved the identification of Gleason ≥ 3+4 prostate cancer compared with mpMRI, with the principal effect being improved risk stratification of intermediate-risk mpMRI lesions. |
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| AbstractList | A prospective single-arm clinical trial was conducted to determine whether
F-choline PET/mpMRI can improve the specificity of multiparametric MRI (mpMRI) of the prostate for Gleason ≥ 3+4 prostate cancer.
Before targeted and systematic prostate biopsy, mpMRI and
F-choline PET/CT were performed on 56 evaluable subjects with 90 Likert score 3-5 mpMRI target lesions, using a
F-choline target-to-background ratio of greater than 1.58 to indicate a positive
F-choline result. Prostate biopsies were performed after registration of real-time transrectal ultrasound with T2-weighted MRI. A mixed-effects logistic regression was applied to measure the performance of mpMRI (based on prospective Likert and retrospective Prostate Imaging Reporting and Data System, version 2 [PI-RADS], scores) compared with
F-choline PET/mpMRI to detect Gleason ≥ 3+4 cancer.
The per-lesion accuracy of systematic plus targeted biopsy for mpMRI alone was 67.8% (area under receiver-operating-characteristic curve [AUC], 0.73) for Likert 4-5 and 70.0% (AUC, 0.76) for PI-RADS 3-5. Several PET/MRI models incorporating
F-choline with mpMRI data were investigated. The most promising model selected all high-risk disease on mpMRI (Likert 5 or PI-RADS 5) plus low- and intermediate-risk disease (Likert 4 or PI-RADS 3-4), with an elevated
F-choline target-to-background ratio greater than 1.58 as positive for significant cancer. Using this approach, the accuracy on a per-lesion basis significantly improved to 88.9% for Likert (AUC, 0.90;
< 0.001) and 91.1% for PI-RADS (AUC, 0.92;
< 0.001). On a per-patient basis, the accuracy improved to 92.9% for Likert (AUC, 0.93;
< 0.001) and to 91.1% for PI-RADS (AUC, 0.91;
= 0.009).
F-choline PET/mpMRI improved the identification of Gleason ≥ 3+4 prostate cancer compared with mpMRI, with the principal effect being improved risk stratification of intermediate-risk mpMRI lesions. |
| Author | Lee, Eunjee Montgomery, Jeffrey S Shao, Xia Kunju, Lakshmi Priya Barnett, Christine Piert, Morand Rajendiran, Thekkelnaycke Davenport, Matthew S Siddiqui, Javed Shankar, Prasad R Denton, Brian |
| Author_xml | – sequence: 1 givenname: Matthew S surname: Davenport fullname: Davenport, Matthew S organization: Urology Department, University of Michigan, Ann Arbor, Michigan – sequence: 2 givenname: Jeffrey S surname: Montgomery fullname: Montgomery, Jeffrey S organization: Urology Department, University of Michigan, Ann Arbor, Michigan – sequence: 3 givenname: Lakshmi Priya surname: Kunju fullname: Kunju, Lakshmi Priya organization: Pathology Department, University of Michigan, Ann Arbor, Michigan – sequence: 4 givenname: Javed surname: Siddiqui fullname: Siddiqui, Javed organization: Pathology Department, University of Michigan, Ann Arbor, Michigan – sequence: 5 givenname: Prasad R surname: Shankar fullname: Shankar, Prasad R organization: Radiology Department, University of Michigan, Ann Arbor, Michigan – sequence: 6 givenname: Thekkelnaycke surname: Rajendiran fullname: Rajendiran, Thekkelnaycke organization: Pathology Department, University of Michigan, Ann Arbor, Michigan – sequence: 7 givenname: Xia surname: Shao fullname: Shao, Xia organization: Radiology Department, University of Michigan, Ann Arbor, Michigan – sequence: 8 givenname: Eunjee surname: Lee fullname: Lee, Eunjee organization: Department of Information and Statistics, Chungnam National University, Daejeon, South Korea – sequence: 9 givenname: Brian surname: Denton fullname: Denton, Brian organization: RTI Health Solutions, Research Triangle Park, North Carolina; and – sequence: 10 givenname: Christine surname: Barnett fullname: Barnett, Christine organization: Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan – sequence: 11 givenname: Morand surname: Piert fullname: Piert, Morand email: mpiert@med.umich.edu organization: Radiology Department, University of Michigan, Ann Arbor, Michigan mpiert@med.umich.edu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31420496$$D View this record in MEDLINE/PubMed |
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| Keywords | prostate cancer PET/MRI interrater agreement 18F-fluoromethylcholine targeted prostate biopsy |
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F-choline PET/mpMRI can improve the specificity of multiparametric MRI (mpMRI) of... |
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| Title | 18 F-Choline PET/mpMRI for Detection of Clinically Significant Prostate Cancer: Part 1. Improved Risk Stratification for MRI-Guided Transrectal Prostate Biopsies |
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