Accuracy of Ga-Prostate-specific Membrane Antigen Positron Emission Tomography for the Detection of Lymph Node Metastases Before Salvage Lymphadenectomy
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Accuracy of Ga-Prostate-specific Membrane Antigen Positron Emission Tomography for the Detection of Lymph Node Metastases Before Salvage Lymphadenectomy. / Mandel, Philipp; Tilki, Derya; Chun, Felix K; Pristupa, Eugenia; Graefen, Markus; Klutmann, Susanne; Budäus, Lars; Steuber, Thomas.
in: EUR UROL FOCUS, Jahrgang 6, Nr. 1, 15.01.2020, S. 71-73.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Accuracy of Ga-Prostate-specific Membrane Antigen Positron Emission Tomography for the Detection of Lymph Node Metastases Before Salvage Lymphadenectomy
AU - Mandel, Philipp
AU - Tilki, Derya
AU - Chun, Felix K
AU - Pristupa, Eugenia
AU - Graefen, Markus
AU - Klutmann, Susanne
AU - Budäus, Lars
AU - Steuber, Thomas
N1 - Copyright © 2018. Published by Elsevier B.V.
PY - 2020/1/15
Y1 - 2020/1/15
N2 - Imaging modalities with high accuracy are essential for proper selection of patients for salvage lymph node dissection (sLND). Unlike nodal staging before radical prostatectomy, data on prostate-specific membrane antigen (PSMA) positron emission tomography (PET) before sLND are scarce. We analyzed 23 patients undergoing 68Ga-PSMA-PET before sLND and compared the imaging findings with histopathology at sLND. Altogether, 29/109 resected lymph node (LN) fields harbored histologically confirmed LN metastases (26.6%)., The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89.5%, 74.1%, 70.8%, 90.9%, and 80.4% in side-based analysis, and 75.9%, 87.5%, 68.8%, 90.9%, and 84.4%, respectively, in LN field-based analysis. In contrast to existing studies, sensitivity in particular was lower. This might be because of referral for sLND on the basis of PSMA-PET from 13 different nuclear medicine centers. However, this could still provide more realistic data if sLND should become widely used. Second, our pathologists routinely used immunohistochemistry, resulting in a higher yield of smaller metastases, increasing the accuracy of histopathology. Despite its acceptable accuracy in a real-world scenario, sLND should not only focus on PSMA-PET-positive fields, as small PSMA-PET-negative metastases may be present.PATIENT SUMMARY: We analyzed the accuracy of prostate-specific membrane antigen positron emission tomography (PSMA-PET) before salvage lymph node dissection in a real-world situation. Although the accuracy is reasonable, resection should not exclusively focus on PSMA-PET-positive fields.
AB - Imaging modalities with high accuracy are essential for proper selection of patients for salvage lymph node dissection (sLND). Unlike nodal staging before radical prostatectomy, data on prostate-specific membrane antigen (PSMA) positron emission tomography (PET) before sLND are scarce. We analyzed 23 patients undergoing 68Ga-PSMA-PET before sLND and compared the imaging findings with histopathology at sLND. Altogether, 29/109 resected lymph node (LN) fields harbored histologically confirmed LN metastases (26.6%)., The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89.5%, 74.1%, 70.8%, 90.9%, and 80.4% in side-based analysis, and 75.9%, 87.5%, 68.8%, 90.9%, and 84.4%, respectively, in LN field-based analysis. In contrast to existing studies, sensitivity in particular was lower. This might be because of referral for sLND on the basis of PSMA-PET from 13 different nuclear medicine centers. However, this could still provide more realistic data if sLND should become widely used. Second, our pathologists routinely used immunohistochemistry, resulting in a higher yield of smaller metastases, increasing the accuracy of histopathology. Despite its acceptable accuracy in a real-world scenario, sLND should not only focus on PSMA-PET-positive fields, as small PSMA-PET-negative metastases may be present.PATIENT SUMMARY: We analyzed the accuracy of prostate-specific membrane antigen positron emission tomography (PSMA-PET) before salvage lymph node dissection in a real-world situation. Although the accuracy is reasonable, resection should not exclusively focus on PSMA-PET-positive fields.
KW - Journal Article
U2 - 10.1016/j.euf.2018.07.025
DO - 10.1016/j.euf.2018.07.025
M3 - SCORING: Journal article
C2 - 30049657
VL - 6
SP - 71
EP - 73
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 1
ER -