Erschienen:
Springer Science and Business Media LLC, 2022
Erschienen in:European Journal of Nuclear Medicine and Molecular Imaging
Sprache:
Englisch
DOI:
10.1007/s00259-022-05787-9
ISSN:
1619-7070;
1619-7089
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Abstract
</jats:title><jats:sec>
<jats:title>Purpose</jats:title>
<jats:p>Recently, a significant association was shown between novel growth patterns on histopathology of prostate cancer (PCa) and prostate-specific membrane antigen (PSMA) uptake on [<jats:sup>68</jats:sup>Ga]PSMA-PET. It is the aim of this study to evaluate the association between these growth patterns and ADC (mm<jats:sup>2</jats:sup>/1000 s) values in comparison to [<jats:sup>68</jats:sup>Ga]PSMA uptake on PET/MRI.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>We retrospectively evaluated patients who underwent [<jats:sup>68</jats:sup>Ga]PSMA PET/MRI for staging or biopsy guidance, followed by radical prostatectomy at our institution between 07/2016 and 01/2020. The dominant lesion per patient was selected based on histopathology and correlated to PET/MRI in a multidisciplinary meeting, and quantified using SUV<jats:sub>max</jats:sub> for PSMA uptake and ADC<jats:sub>mean</jats:sub> for diffusion restriction. PCa growth pattern was classified as expansive (EXP) or infiltrative (INF) according to its properties of forming a tumoral mass or infiltrating diffusely between benign glands by two independent pathologists. Furthermore, the corresponding WHO2016 ISUP tumor grade was evaluated. The <jats:italic>t</jats:italic> test was used to compare means, Pearson’s test for categorical correlation, Cohen’s kappa test for interrater agreement, and ROC curve to determine the best cutoff.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>Sixty-two patients were included (mean PSA 11.7 ± 12.5). The interrater agreement between both pathologists was almost perfect with <jats:italic>κ</jats:italic> = 0.81. While 25 lesions had an EXP-growth with an ADC<jats:sub>mean</jats:sub> of 0.777 ± 0.109, 37 showed an INF-growth with a significantly higher ADC<jats:sub>mean</jats:sub> of 1.079 ± 0.262 (<jats:italic>p</jats:italic> < 0.001). We also observed a significant difference regarding PSMA SUV<jats:sub>max</jats:sub> for the EXP-growth (19.2 ± 10.9) versus the INF-growth (9.4 ± 6.2, <jats:italic>p</jats:italic> < 0.001). Within the lesions encompassing the EXP- or the INF-growth, no significant correlation between the ISUP groups and ADC<jats:sub>mean</jats:sub> could be observed (<jats:italic>p</jats:italic> = 0.982 and <jats:italic>p</jats:italic> = 0.861, respectively).</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>PCa with INF-growth showed significantly lower SUV<jats:sub>max</jats:sub> and higher ADC<jats:sub>mean</jats:sub> values compared to PCa with EXP-growth. Within the growth groups, ADC<jats:sub>mean</jats:sub> values were independent from ISUP grading.</jats:p>
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