Universität zu Köln

Lennartz, Simon, Taeger, Philipp, Zopfs, David, Iuga, Andra-Iza, Reimer, Robert Peter, Zaeske, Charlotte, Grosse Hokamp, Nils, Maintz, David, Heidenreich, Axel, Drzezga, Alexander ORCID: 0000-0001-6018-716X, Kobe, Carsten and Persigehl, Thorsten (2021). Lymph Node Assessment in Prostate Cancer Evaluation of Iodine Quantification With Spectral Detector CT in Correlation to PSMA PET/CT. Clin. Nucl. Med., 46 (4). S. 303 - 310. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-0229

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Abstract

Purpose The aims of this study were to evaluate spectral detector CT (SDCT)-derived iodine concentration (IC) of lymph nodes diagnosed as metastatic and benign in prostate-specific membrane antigen (PSMA) PET/CT and to assess its potential use for lymph node assessment in prostate cancer. Patients and Methods Thirty-four prostate cancer patients were retrospectively included: 16 patients with and 18 without lymph node metastases as determined by PSMA PET/CT. Patients underwent PSMA PET/CT as well as portal venous phase abdominal SDCT for clinical cancer follow-up. Only scan pairs with a stable nodal status indicated by constant size as well as comparable prostate-specific antigen (PSA) levels were included. One hundred benign and 96 suspected metastatic lymph nodes were annotated and correlated between SDCT and PSMA PET/CT. Iodine concentration in SDCT-derived iodine maps and SUVmax in ultra-high definition reconstructions from PSMA PET/CT were acquired based on the region of interest. Results Metastatic lymph nodes as per PSMA PET/CT showed higher IC than nonmetastatic nodes (1.9 +/- 0.6 mg/mL vs 1.5 +/- 0.5 mg/mL, P < 0.05) resulting in an AUC of 0.72 and sensitivity/specificity of 81.3%/58.5%. The mean short axis diameter of metastatic lymph nodes was larger than that of nonmetastatic nodes (6.9 +/- 3.6 mm vs 5.3 +/- 1.3 mm; P < 0.05); a size threshold of 1 cm short axis diameter resulted in a sensitivity/specificity of 12.8%/99.0%. There was a significant yet weak positive correlation between SUVmax and IC (r(s) = 0.25; P < 0.001). Conclusions Spectral detector CT-derived IC was increased in lymph nodes diagnosed as metastatic in PSMA PET/CT yet showed considerable data overlap. The correlation between IC and SUVmax was weak, highlighting the role of PSMA PET/CT as important reference imaging modality for detection of lymph node metastases in prostate cancer patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Taeger, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Iuga, Andra-Iza UNSPECIFIED UNSPECIFIED UNSPECIFIED Reimer, Robert Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaeske, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Grosse Hokamp, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED orcid.org/0000-0001-6018-716X UNSPECIFIED Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-586089
DOI:	10.1097/RLU.0000000000003496
Journal or Publication Title:	Clin. Nucl. Med.
Volume:	46
Number:	4
Page Range:	S. 303 - 310
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-0229
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; COMPUTED-TOMOGRAPHY; METASTASES Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58608