Preoperative evaluation of prostate cancer by 68Ga-PMSA positron emission tomography/computed tomography: comparison with magnetic resonance imaging and with histopathological findings.

Abstract

Objective: To evaluate the accuracy of preoperative positron emission tomography/computed tomography with ⁶⁸Ga-labeled prostate-specific membrane antigen (⁶⁸Ga-PSMA PET/CT) for staging prostate cancer and compare it with magnetic resonance imaging (MRI) using histopathology of surgical specimens as the gold standard.

Materials and methods: In this retrospective study, 65 patients with prostate cancer were analyzed.

Results: The accuracy of ⁶⁸Ga-PSMA PET/CT for tumor detection was 95%, and that of MRI was 91%. There was no difference between ⁶⁸Ga-PSMA PET/CT and MRI regarding localization of the lesion. The sensitivity of ⁶⁸Ga-PSMA PET/CT for detecting extraprostatic extension was quite low (14%). For detection of seminal vesicle invasion, ⁶⁸Ga-PSMA PET/CT showed a sensitivity of 57% and accuracy of 91%. There was a moderate correlation between the maximum standardized uptake value (SUVmax) and the serum level of prostate-specific antigen (p < 0.01; ρ = 0.368) and between the SUVmax and the International Society of Urological Pathology (ISUP) grade (p < 0.01; ρ = 0.513).

Conclusion: ⁶⁸Ga-PSMA PET/CT is a promising tool for detecting and evaluating the primary tumor, which can alter the staging and management of the disease.