BMC Urology (Dec 2023)

Prediction of T staging in PI-RADS 4–5 prostate cancer by combination of multiparametric MRI and 68Ga-PSMA-11 PET/CT

  • Yuanzhen Ding,
  • Chenghao Mo,
  • Qiubo Ding,
  • Tingsheng Lin,
  • Jie Gao,
  • Mengxia Chen,
  • Wenfeng Lu,
  • Jiyuan Sun,
  • Feng Wang,
  • Shiming Zang,
  • Qing Zhang,
  • Shiwei Zhang,
  • Hongqian Guo

DOI
https://doi.org/10.1186/s12894-023-01376-6
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 10

Abstract

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Abstract Background In this study, we explored the diagnostic performances of multiparametric magnetic resonance imaging (mpMRI), 68 Ga-PSMA-11 PET/CT and combination of 68 Ga-PSMA-11 PET/CT and mpMRI (mpMRI + PET/CT) for extracapsular extension (ECE). Based on the analyses above, we tested the feasibility of using mpMRI + PET/CT results to predict T staging in prostate cancer patients. Methods By enrolling 75 patients of prostate cancer with mpMRI and 68 Ga-PSMA-11 PET/CT before radical prostatectomy, we analyzed the detection performances of ECE in mpMRI, 68 Ga-PSMA-11 PET/CT and mpMRI + PET/CT on their lesion images matched with their pathological sample images layer by layer through receiver operating characteristics (ROC) analysis. By inputting the lesion data into Prostate Imaging Reporting and Data System (PI-RADS), we divided the lesions into different PI-RADS scores. The improvement of detecting ECE was analyzed by net reclassification improvement (NRI). The predictors for T staging were evaluated by using univariate and multivariable analysis. The Kappa test was used to evaluate the prediction ability. Results One hundred three regions of lesion were identified from 75 patients. 50 of 103 regions were positive for ECE. The ECE diagnosis AUC of mpMRI + PET/CT is higher than that of mpMRI alone (ΔAUC = 0.101; 95% CI, 0.0148 to 0.1860; p < 0.05, respectively). Compared to mpMRI, mpMRI + PET/CT has a significant improvement in detecting ECE in PI-RADS 4–5 (NRI 36.1%, p < 0.01). The diagnosis power of mpMRI + PET/CT was an independent predictor for T staging (p < 0.001) in logistic regression analysis. In patients with PI-RADS 4–5 lesions, 40 of 46 (87.0%) patients have correct T staging prediction from mpMRI + PET/CT (κ 0.70, p < 0.01). Conclusion The prediction of T staging in PI-RADS 4–5 prostate cancer patients by mpMRI + PET/CT had a quite good performance.

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