AI Article Synopsis
- The study compared the effectiveness of Ga-PSMA-PET and Tc-DPD-SPECT in assessing bone lesions in prostate cancer patients, with an aim to see how low-dose CT enhanced the results.* -
- Analyzing data from 54 patients, Ga-PSMA-PET showed higher accuracy (AUC 1.00) in detecting bone metastases compared to Tc-DPD-SPECT (AUC 0.86), especially benefiting from additional CT information in reducing uncertain findings.* -
- The findings highlight that Ga-PSMA-PET is superior for skeletal staging in prostate cancer, and combining it with CT significantly improves the clarity of ambiguous diagnoses compared to using SPECT alone.*
Article Abstract
Purpose: This study compared Gallium-prostate-specific-membrane-antigen based Positron-emission-tomography (Ga-PSMA-PET) and technetium-3,3-diphospho-1,2-propanedicarbonacid (Tc-DPD-SPECT) in performing skeletal staging in prostate cancer (PC) patients and evaluated the additional value of the information from low-dose-computed tomography (CT).
Materials And Methods: In this retrospective study, 54 patients who received Ga-PSMA-PET/CT and Tc-DPD-SPECT/CT within 80 days were extracted from our database. Osseous lesions were classified as benign, malignant or equivocal. Lesion, region and patient based analysis was performed with and without CT fusion. The reference standard was generated by defining a best valuable comparator (BVC) containing information from all available data.
Results: In the patient based analysis, accuracies measured as "area-under-the-curve" (AUC) for Ga-PSMA-PET, Tc-SPECT, Ga-PSMA-PET/CT and Tc-SPECT/CT were 0.97-0.96, 0.86-0.83, 1.00 and 0.83, respectively (p<0.05) (ranges = optimistic vs. pessimistic view). Region based analysis resulted in the following sensitivities and specificities: 91.8-97.7%, 100-99.5% (PET); 61.2-70.6%, 99.8-98.3% (SPECT); 97.7%, 100% (PET/CT), 69.4% and 98.3% (SPECT/CT) (p<0.05). The amount of correct classifications of equivocal lesions by CT was significantly higher in PET (100%) compared to SPECT (52.4%) (p<0.05).
Conclusion: Ga-PSMA-PET outperforms Tc-DPD-SPECT in detecting bone metastases in PC patients. Additional information from low-dose-CT resulted in a significant reduction in equivocal lesions in both modalities, however Ga-PSMA-PET benefited most.
Key Points: • Ga-PSMA-PET outperforms Tc-DPD-SPECT in skeletal staging in prostate cancer patients • Proportion of equivocal decisions was significantly reduced by CT-fusion in both modalities • Ga-PSMA-PET benefits more from CT information, compared to Tc-DPD-SPECT.
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| http://dx.doi.org/10.1007/s00330-017-4994-6 | DOI Listing |
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