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Accurate assessment of lymph node metastases (LN) in patients with prostate cancer (PCa) is essential for prognosis and patient management. Positron Emission Tomography / Computed Tomography (PET / CT) Prostate Specific Membrane Antigen (PSMA) and Ferumoxtran-10 Nanoparticle Enhanced Magnetic Resonance Imaging (Nano-MRI) are modalities of High potential imaging to identify LN metastases in PCa patients. The objective of this study is to compare the results of these imaging technologies in terms of characteristics and anatomical location of suspect LNs in order to assess the feasibility of their complementary use for imaging in PCa patients. Methods: A total of 45 patients with primary (n = 8) or relapsed (n = 36) PCa were included in this retrospective study. All patients underwent both PSMA-PET / CT and nano-MRI between October 2015 and July 2017 within three weeks. Both scans were performed in the same facility according to local clinical protocols. All scans were independently analyzed by physicians and radiologists with experience in nuclear medicine. Size, anatomical location, and level of suspicion (LoS) were determined for all visible LNs. Subsequently, the results of PSMA-PET / CT and nano-MRI were compared, independently of a reference standard. Results: 179 suspect LNs were identified. Significantly more suspect LNs per patient were detected by nano-MRI (p <0.001): 160 were identified in 33 patients by nano-MRI, against 71 in 25 patients by PSMA-PET / CT. Of all suspect LNs, 108 were identified only by nano-MRI (60%), 19 (11%) were detected only by PSMA-PET / CT, and 52 (29%) were found by both methods. The mean size of suspect LNs identified by nano-MRI was significantly smaller (5.3 mm) than those detected by PSMA-PET / CT (6.0 mm; P = 0.006). The median LoS did not differ significantly. Both modalities identified suspect LNs in all anatomical regions of the pelvis. Conclusion: Both modalities identified suspicious LNs that were missed by the other. Both modalities identified suspect LNs in all anatomical regions of the pelvis, but nano-MRI appeared to be superior at detecting suspect smaller LNs. These results suggest a potential complementary role of nano-MRI to PSMA-PET / CT, however, since the clinical implications of the different results are not yet well established, further research into this complementary use is encouraged.
Journal of Nuclear Medicine: official publication, Society of Nuclear Medicine. Jan 30, 2021 [Epub ahead of print]
Melline Gm Schilham, Patrik Zamecnik, Bastiaan M Privé, Bas Israel, Mark Rijpkema, Tom Scheenen, Jelle O Barentsz, James Nagarajah, Martin Gotthardt
Radboudumc Nijmegen, The Netherlands., Radboud University Medical Center, The Netherlands., Radboud University Medical Center.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/33517328
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