Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 4944  
Year : 2018  |  Volume : 17  |  Issue : 4  |  Page : 261-269

Initial risk stratification and staging in prostate cancer with prostatic-specific membrane antigen positron emission tomography/computed tomography: A first-stop-shop

1 Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2 Department of Uro-Gynae Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
3 Amity Centre for Radiation Biology, Amity University, Noida, Uttar Pradesh, India
4 Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Correspondence Address:
Manoj Gupta
Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, New Delhi - 110 085
Login to access the Email id

DOI: 10.4103/wjnm.WJNM_79_17

Rights and Permissions

Current imaging for prostate cancer (PCa) had limitations for risk stratification and staging. Magnetic resonance imaging frequently underestimated lymph node metastasis while bone scintigraphy often had diagnostic dilemmas. Prostatic-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET/CT) has been remarkable in PCa recurrence. Ninety-seven PSMA PET-CT scans were reanalyzed for tumor node metastases staging and risk stratification of lymph node and distant metastasis proportion. Histopathology of 23/97 patients was available as gold standard. Chi-square test was used for proportion comparison. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), overestimation, underestimation, and correct estimation of T and N stages were calculated. Kappa coefficient (κ) was derived for inter-rater agreement. Lymph node or distant metastasis detection on PSMA PET/CT increased significantly with increase in risk category. PSMA PET/CT sensitivity, specificity, PPV, and NPV for extraprostatic extension, seminal vesicle invasion, and lymph node metastases were 63.16%, 100%, 100%, 36.36%; 55%, 100%, 100%, 25%; and 65.62%, 99.31%, 87.50%, and 97.53%, respectively. Kappa coefficient showed substantial agreement between PSMA PET/CT and histopathological lymph node metastases (κ = 0.734); however, it was just in fair agreement (κ = 0.277) with T stage. PSMA PET/CT overestimated, underestimated, and correct estimated T and N stages in 8.71%, 39.13%, 52.17% and 8.71%, 4.35%, and 86.96% cases, respectively. PSMA PET/CT has potential for initial risk stratification with reasonable correct N stage estimation, however underestimates T stage. Hence, we concluded that PSMA PET/CT should be used as “ first-stop-shop” for staging and initial risk stratification of PCa with regional magnetic resonance imaging in surgically resectable cases.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded265    
    Comments [Add]    
    Cited by others 7    

Recommend this journal