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000131624 0247_ $$2doi$$a10.2967/jnumed.116.185033
000131624 0247_ $$2pmid$$apmid:28637799
000131624 0247_ $$2ISSN$$a0022-3123
000131624 0247_ $$2ISSN$$a0097-9058
000131624 0247_ $$2ISSN$$a0161-5505
000131624 0247_ $$2ISSN$$a1535-5667
000131624 0247_ $$2ISSN$$a2159-662X
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000131624 037__ $$aDKFZ-2017-06256
000131624 041__ $$aeng
000131624 082__ $$a610
000131624 1001_ $$aVinsensia, Maria$$b0
000131624 245__ $$a68Ga-PSMA PET/CT and Volumetric Morphology of PET-Positive Lymph Nodes Stratified by Tumor Differentiation of Prostate Cancer.
000131624 260__ $$aNew York, NY$$bSoc.$$c2017
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000131624 520__ $$a68Ga-prostate-specific membrane antigen (PSMA) PET/CT is a new method to detect early nodal metastases in patients with biochemical relapse of prostate cancer. In this retrospective investigation, the dimensions, volume, localization, and SUVmax of nodes identified by 68Ga-PSMA were correlated to their Gleason score (GS) at diagnosis. Methods: All PET/CT images were acquired 60 ± 10 min after intravenous injection of 68Ga-PSMA (mean dose, 176 MBq). In 147 prostate cancer patients (mean age, 68 y; range, 44-87 y) with prostate-specific antigen relapse (mean prostate-specific antigen level, 5 ng/mL; range, 0.25-294 ng/mL), 362 68Ga-PSMA PET-positive lymph nodes (LNs) were identified. These patients were classified on the basis of their histopathology at primary diagnosis into either low- (GS ≤ 6, well differentiated), intermediate- (GS = 7, moderately differentiated), or high-GS cohorts (GS ≥ 8, poorly differentiated prostate cancer). Using semiautomated LN segmentation software (Fraunhofer MEVIS), we measured node volume and short-axis dimensions (SADs) and long-axis dimensions based on CT and compared with the SUVmax Nodes demonstrating uptake of 68Ga-PSMA with an SUVmax of 2.0 or more were considered PSMA-positive, and nodes with an SAD of 8 mm or more were considered positive by morphologic criteria. Results: Mean SUVmax was 13.5 (95% confidence interval [CI], 10.9-16.1), 12.4 (95% CI, 9.9-14.9), and 17.8 (95% CI, 15.4-20.3) within the low-, intermediate-, and high-GS groups, respectively. The morphologic assessment of the 68Ga-PSMA-positive LN demonstrated that the low-GS cohort presented with smaller 68Ga-PSMA-positive LNs (mean SAD, 7.7 mm; n = 113), followed by intermediate- (mean SAD, 9.4 mm; n = 122) and high-GS cohorts (mean SAD, 9.5 mm; n = 127). On the basis of the CT morphology criteria, only 34% of low-GS patients, 56% of intermediate-GS patients, and 53% of high-GS patients were considered CT positive. Overall, 68Ga-PSMA imaging led to a reclassification of stage in 90 patients (61%) from cN0 to cN1 over CT. Conclusion:68Ga-PSMA PET is a promising modality in biochemical recurrent prostate cancer patients for N staging. Conventional imaging underestimates LN involvement compared with PSMA molecular staging score in each GS cohort. The sensitivity of 68Ga-PSMA PET/CT enables earlier detection of subcentimeter LN metastases in the biochemical recurrence setting.
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000131624 650_7 $$2NLM Chemicals$$a(68Ga)Glu-urea-Lys(Ahx)-HBED-CC
000131624 650_7 $$2NLM Chemicals$$aAntigens, Surface
000131624 650_7 $$2NLM Chemicals$$aOrganometallic Compounds
000131624 650_7 $$2NLM Chemicals$$aRadiopharmaceuticals
000131624 650_7 $$0EC 3.4.17.21$$2NLM Chemicals$$aGlutamate Carboxypeptidase II
000131624 650_7 $$0EC 3.4.17.21$$2NLM Chemicals$$aglutamate carboxypeptidase II, human
000131624 7001_ $$aChyoke, Peter L$$b1
000131624 7001_ $$aHadaschik, Boris$$b2
000131624 7001_ $$0P:(DE-He78)457c042884c901eb0a02c18bb1d30103$$aHolland-Letz, Tim$$b3$$udkfz
000131624 7001_ $$aMoltz, Jan$$b4
000131624 7001_ $$0P:(DE-He78)9793347ba83f527b81a22ab75af9378a$$aKopka, Klaus$$b5$$udkfz
000131624 7001_ $$aRauscher, Isabel$$b6
000131624 7001_ $$aMier, Walter$$b7
000131624 7001_ $$aSchwaiger, Markus$$b8
000131624 7001_ $$0P:(DE-He78)13a0afba029f5f64dc18b25ef7499558$$aHaberkorn, Uwe$$b9$$udkfz
000131624 7001_ $$aMauer, Tobias$$b10
000131624 7001_ $$aKratochwil, Clemens$$b11
000131624 7001_ $$aEiber, Matthias$$b12
000131624 7001_ $$0P:(DE-He78)5ca7e97b2769bb97f8c73431c6566b94$$aGiesel, Frederik$$b13$$eLast author$$udkfz
000131624 773__ $$0PERI:(DE-600)2040222-3$$a10.2967/jnumed.116.185033$$gVol. 58, no. 12, p. 1949 - 1955$$n12$$p1949 - 1955$$tJournal of nuclear medicine$$v58$$x2159-662X$$y2017
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