Added Value of Whole-Body Diffusion-Weighted Imaging in Patients Undergoing Prostate-Specific Membrane Antigen Positron Emission Tomography
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View abstract on PubMed
Summary
This summary is machine-generated.Whole-body diffusion-weighted imaging (DWI) combined with Prostate-Specific Membrane Antigen (PSMA) PET scans helps identify PSMA-negative metastatic castration-resistant prostate cancer (mCRPC). This imaging approach aids in better risk stratification for patients undergoing radioligand therapy.
Area Of Science
- Oncology
- Radiology
- Medical Imaging
Background
- Metastatic castration-resistant prostate cancer (mCRPC) patients with PSMA-negative disease have poorer outcomes with radioligand therapy (RLT).
- Accurate identification of PSMA-negative disease is crucial for effective patient management and risk stratification.
Purpose Of The Study
- To evaluate the added value of whole-body (WB) diffusion-weighted imaging (DWI) to PSMA PET in detecting PSMA-negative lesions.
- To assess the impact of identifying PSMA-negative disease on patient outcomes.
Main Methods
- Retrospective review of consecutive PSMA PET/MRI exams including WB DWI in mCRPC patients.
- Two independent readers assessed 14 anatomic locations for lesion detection on both WB DWI and PSMA PET.
- Inter-reader agreement was calculated using intra-class correlation coefficients (ICCs).
Main Results
- WB DWI identified PSMA-negative lesions in 24% of the 41 included patients.
- Both modalities showed good inter-reader agreement, with PSMA PET (ICC: 0.87) showing higher agreement than DWI (ICC: 0.72).
- Patients with mismatched disease (PSMA-negative lesions) had a median overall survival of 442 days versus 523 days for those without, a difference that was not statistically significant.
Conclusions
- The integration of WB DWI with PSMA PET can identify PSMA-negative disease in mCRPC patients.
- This combined imaging approach has the potential to influence treatment decisions and improve patient management strategies.
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