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DIAGNOSTIC ACCURACY OF 68Ga-PSMA PET/MRI AND MULTIPARAMETRIC MRI IN DETECTING INDEX TUMOR IN RADICAL PROSTATECTOMY SPECIMEN
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  • UGUR COSAR,
  • Ilker Sen,
  • Uguray Aydos ,
  • Murat Yavuz Koparal,
  • Murat Ucar ,
  • Nil Tokgoz,
  • Ipek Isık Gonul,
  • Umit Ozgur Akdemir ,
  • Lutfiye Ozlem Atay ,
  • Sinan Sözen
UGUR COSAR
Gazi University Faculty of Medicine
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Ilker Sen
Gazi University Faculty of Medicine
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Uguray Aydos
Gazi University Faculty of Medicine
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Murat Yavuz Koparal
Recep Tayyip Erdogan University Training and Research Hospital
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Murat Ucar
Gazi University Faculty of Medicine
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Nil Tokgoz
Gazi University Faculty of Medicine
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Ipek Isık Gonul
Gazi University Faculty of Medicine
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Umit Ozgur Akdemir
Gazi University Faculty of Medicine
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Lutfiye Ozlem Atay
Gazi University Faculty of Medicine
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Sinan Sözen
Gazi University Faculty of Medicine
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Abstract

ABSTRACT Objective To evaluate the diagnostic accuracy of the 68Gallium (68Ga) - prostate specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) and multiparametric MRI (mpMRI) by region-based comparison of index tumour localisations using histopathological tumour maps of patients who underwent radical prostatectomy due to clinically significant prostate cancer. Patients and Methods The study included 64 patients who underwent radical prostatectomy after primary staging with mpMRI and 68Ga-PSMA PET/MRI. Diagnostic analysis was performed by dividing the prostate into four anatomic regions as left/right anterior and left/right posterior. The extension of the lesions in mpMRI and the pathological uptake in 68Ga-PSMA PET/MRI were matched separately for each region with the extension of the index tumour into each region. Results The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and the accuracy of mpMRI and 68Ga-PSMA PET/MRI are shown as 55.7%, 91.8%, 80.6%, 77.2%, 78.1% and 60.8%, 94.3%, 86.8% 79.8%, 83.5%, respectively. 68Ga-PSMA PET/MRI has higher sensitivity and specificity compared with mpMRI. However, no statistically significant difference was found (p = 0.464). Combined imaging had significantly higher diagnostic accuracy compared with mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.084 and 0.046, p < 0.001 and p = 0.028, respectively), while no statistically significant difference was found between mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.038, p = 0.246). Conclusion 68Ga-PSMA PET/MRI had higher clinical diagnostic accuracy in prostate cancer compared with mpMRI. Diagnostic accuracy was significantly increased in the combined use of both imaging modalities.

Peer review status:ACCEPTED

28 Jan 2021Submitted to International Journal of Clinical Practice
15 Feb 2021Submission Checks Completed
15 Feb 2021Assigned to Editor
21 Feb 2021Reviewer(s) Assigned
23 Feb 2021Review(s) Completed, Editorial Evaluation Pending
22 Mar 20211st Revision Received
26 Mar 2021Submission Checks Completed
26 Mar 2021Assigned to Editor
14 Apr 2021Reviewer(s) Assigned
15 Apr 2021Review(s) Completed, Editorial Evaluation Pending
26 Apr 2021Editorial Decision: Accept