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@ARTICLE{Freitag:120596,
      author       = {M. Freitag$^*$ and J. P. Radtke$^*$ and A.
                      Afshar-Oromieh$^*$ and M. C. Roethke$^*$ and B. A. Hadaschik
                      and M. Gleave and D. Bonekamp$^*$ and K. Kopka$^*$ and M.
                      Eder$^*$ and T. Heusser$^*$ and M. Kachelriess$^*$ and K.
                      Wieczorek and C. Sachpekidis$^*$ and P. Flechsig and F.
                      Giesel$^*$ and M. Hohenfellner and U. Haberkorn$^*$ and
                      H.-P. Schlemmer$^*$ and A. Dimitrakopoulou-Strauss$^*$},
      title        = {{L}ocal recurrence of prostate cancer after radical
                      prostatectomy is at risk to be missed in
                      (68){G}a-{PSMA}-11-{PET} of {PET}/{CT} and {PET}/{MRI}:
                      comparison with mp{MRI} integrated in simultaneous
                      {PET}/{MRI}.},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {44},
      number       = {5},
      issn         = {1619-7089},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {DKFZ-2017-01024},
      pages        = {776 - 787},
      year         = {2017},
      abstract     = {The positron emission tomography (PET) tracer
                      (68)Ga-PSMA-11, targeting the prostate-specific membrane
                      antigen (PSMA), is rapidly excreted into the urinary tract.
                      This leads to significant radioactivity in the bladder,
                      which may limit the PET-detection of local recurrence (LR)
                      of prostate cancer (PC) after radical prostatectomy (RP),
                      developing in close proximity to the bladder. Here, we
                      analyze if there is additional value of multi-parametric
                      magnetic resonance imaging (mpMRI) compared to the
                      (68)Ga-PSMA-11-PET-component of PET/CT or PET/MRI to detect
                      LR.One hundred and nineteen patients with biochemical
                      recurrence after prior RP underwent both hybrid
                      (68)Ga-PSMA-11-PET/CTlow-dose (1 h p.i.) and -PET/MRI
                      (2-3 h p.i.) including a mpMRI protocol of the prostatic
                      bed. The comparison of both methods was restricted to the
                      abdomen with focus on LR (McNemar). Bladder-LR distance and
                      recurrence size were measured in axial T2w-TSE. A logistic
                      regression was performed to determine the influence of these
                      variables on detectability in (68)Ga-PSMA-11-PET.
                      Standardized-uptake-value (SUVmean) quantification of LR was
                      performed.There were 93/119 patients that had at least one
                      pathologic finding. In addition, 18/119 Patients $(15.1\%)$
                      were diagnosed with a LR in mpMRI of PET/MRI but only nine
                      were PET-positive in PET/CT and PET/MRI. This mismatch was
                      statistically significant (p = 0.004). Detection of LR
                      using the PET-component was significantly influenced by
                      proximity to the bladder (p = 0.028). The PET-pattern of
                      LR-uptake was classified into three types (1): separated
                      from bladder; (2): fuses with bladder, and (3): obliterated
                      by bladder). The size of LRs did not affect
                      PET-detectability (p = 0.84), mean size was
                      1.7 ± 0.69 cm long axis, 1.2 ± 0.46 cm
                      short-axis. SUVmean in nine men was 8.7 ± 3.7 (PET/CT)
                      and 7.0 ± 4.2 (PET/MRI) but could not be quantified in
                      the remaining nine cases (obliterated by bladder).The
                      present study demonstrates additional value of hybrid
                      (68)Ga-PSMA-11-PET/MRI by gaining complementary diagnostic
                      information compared to (the 68)Ga-PSMA-11-PET/CTlow-dose
                      for patients with LR of PC.},
      keywords     = {(68Ga)Glu-urea-Lys(Ahx)-HBED-CC (NLM Chemicals) /
                      Organometallic Compounds (NLM Chemicals)},
      cin          = {E010 / E060 / E030 / E020},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)E060-20160331 /
                      I:(DE-He78)E030-20160331 / I:(DE-He78)E020-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27988802},
      doi          = {10.1007/s00259-016-3594-z},
      url          = {https://inrepo02.dkfz.de/record/120596},
}