Prediction of T staging in PI-RADS 4-5 prostate cancer by combination of multiparametric MRI and 68Ga-PSMA PET/CT

Author:

Ding Yuanzhen1,Mo Chenghao2,Ding Qiubo3,Lin Tingsheng1,Gao Jie1,Chen Mengxia1,Lu Wenfeng1,Sun Jiyuan1,Wang Feng4,Zang Shiming4,Zhang Qing1,Zhang Shiwei1,Guo Hongqian1

Affiliation:

1. Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University

2. Drum Tower Hospital Clinical College of Nanjing Medical University

3. Drum Tower Hospital Clinical College of Xuzhou Medical University

4. Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University

Abstract

Abstract Background To explore the diagnostic performance of Multiparametric magnetic resonance imaging (mpMRI), 68Ga-PSMA PET/CT (PET/CT) and combination of 68Ga-PSMA PET/CT and mpMRI (mpMRI + PET/CT) for extracapsular extension (ECE). Based on the results, to predict T staging in prostate cancer.Methods By enrolling 75 patients of prostate cancer with mpMRI and PET/CT before radical prostatectomy, we analyzed the detection performance of ECE in mpMRI, PET/CT and mpMRI + PET/CT using receiver operating characteristics (ROC) analysis. Dividing the lesions into different PI-RADS score, the improvement was analyzed by net reclassification improvement (NRI). Predictors for T staging were evaluated by using univariate and multivariable analysis. The Kappa test was used to evaluate the prediction ability.Results From 75 patients, 50 of 103 regions were positive for ECE. AUC of mpMRI + PET/CT improved ECE diagnosis compared to mpMRI alone respectively (ΔAUC = 0.101; 95% CI, 0.0148 to 0.1860; p < 0.05, respectively). Comparing mpMRI + PET/CT to mpMRI, lesions with PI-RADS 4–5 had a significant improvement (NRI 36.1%, p < 0.01). The diagnosis of mpMRI + PET/CT was an independent predictor (p < 0.001) in logistic regression analysis. In patients with PI-RADS 4–5 lesions, 40 of 46 (87.0%) patients has correct T staging prediction (κ 0.70, p < 0.01).Conclusion The prediction of T staging in PI-RADS 4–5 prostate cancer by mpMRI + PET/CT had a moderate performance.

Publisher

Research Square Platform LLC

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