Comparison of 68Ga-PSMA-I/T PET-CT and Multiparametric MRI for Locoregional Staging of Prostate Cancer Patients: A Pilot Study

Bladder Cancer

Urol Int. 2020 Aug 4:1-8. doi: 10.1159/000509974. Online ahead of print.


BACKGROUND/AIM: The objective of this work was to assess the value of 68Ga-DOTAGA-(3-iodo-y)fk(Sub-KuE) positron emission tomography (68Ga-PSMA-I/T PET-CT) and multiparametric magnetic resonance imaging (mp-MRI) for preoperative staging in prostate cancer (PCa) patients who underwent radical prostatectomy (RP) by validating with postoperative histopathology data.

MATERIALS AND METHODS: We prospectively investigated 30 consecutive PCa patients who had both mp-MRI and 68Ga-PSMA-I/T PET-CT before laparoscopic RP. The seminal vesicle invasion (SVI), lymph node metastasis (LNM), bladder neck invasion (BNI), and extracapsular extension (ECE) were investigated separately. The diagnostic performances of mp-MRI and 68Ga-PSMA-I/T PET-CT were assessed using histopathological results.

RESULTS: Both mp-MRI and 68Ga-PSMA-I/T PET-CT were not statistically significant in the evaluation of SVI, BNI, and ECE preoperatively but had statistically significant results in the assessment of LNM. mp-MRI had higher overall sensitivity for ECE, overall specificity for SVI, ECE, and BNI, and positive predictive value for ECE, SVI, BNI. 68Ga-PSMA-I/T PET-CT had higher overall sensitivity for BNI, and negative predictive value for BNI and LNM.

CONCLUSION: mp-MRI has superior specificity, sensitivity, and accuracy for assessing ECE and SVI. Both imaging modalities had similar specificity, sensitivity, and accuracy for determining BNI. However, both imaging modalities had low diagnostic accuracy for LNM on histopathology.