Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer

Purpose: Magnetic resonance imaging (MRI) with multiparametric assessment is a cornerstone in radiation therapy planning for primary prostate cancer (PCa), offering the potential for focal dose escalation to dominant intraprostatic lesions to enhance PCa management. The prostate-specific membrane an...

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Main Authors: Hamed Bagheri, PhD, Seied Rabi Mahdavi, PhD, Parham Geramifar, PhD, Ali Neshasteh-Riz, PhD, Masoumeh Sajadi-Rad, MD, Habibollah Dadgar, PhD, Hossein Arabi, PhD, Habib Zaidi, PhD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Advances in Radiation Oncology
Online Access:http://www.sciencedirect.com/science/article/pii/S2452109425001083
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author Hamed Bagheri, PhD
Seied Rabi Mahdavi, PhD
Parham Geramifar, PhD
Ali Neshasteh-Riz, PhD
Masoumeh Sajadi-Rad, MD
Habibollah Dadgar, PhD
Hossein Arabi, PhD
Habib Zaidi, PhD
author_facet Hamed Bagheri, PhD
Seied Rabi Mahdavi, PhD
Parham Geramifar, PhD
Ali Neshasteh-Riz, PhD
Masoumeh Sajadi-Rad, MD
Habibollah Dadgar, PhD
Hossein Arabi, PhD
Habib Zaidi, PhD
author_sort Hamed Bagheri, PhD
collection DOAJ
description Purpose: Magnetic resonance imaging (MRI) with multiparametric assessment is a cornerstone in radiation therapy planning for primary prostate cancer (PCa), offering the potential for focal dose escalation to dominant intraprostatic lesions to enhance PCa management. The prostate-specific membrane antigen (PSMA), which is frequently overexpressed in PCa, has led to the development of 68Ga-labeled PSMA inhibitors for positron emission tomography (PET)/computed tomography (CT), showing promising results in PCa detection. This study aimed to conduct a comparative analysis of 68Ga-PSMA PET/CT and multiparametric MRI (mpMRI) in delineating the gross tumor volume (GTV) in PCa. Methods and Materials: A retrospective analysis was performed on 25 PCa patients who underwent 68Ga-PSMA PET/CT and mpMRI at 2 distinct centers. The GTVs were delineated on MRI (GTV-MRI) by 2 nuclear medicine physicians and 1 radiation oncologist independently, while the GTVs based on PET/CT (GTV-PET) were outlined by 2 nuclear medicine physicians. The laterality (left, right, and bilateral) prostate lobes on mpMRI and PET/CT was assessed. To account for registration uncertainties, both GTV-PET and GTV-MRI were expanded isotropically by 5 mm to form the planning target volume (PTV), and the overlap between specific PTVs and their corresponding GTVs was quantified. Results: The average ± SD GTV-MRI and GTV-PET were 5.468 ± 11.6 cm³ and 11.136 ± 14.3 cm³, respectively, with the GTV-PET being significantly larger than the GTV-MRI (P = .003). GTV-MRI exhibited an intersection with GTV-PET of 3.5 ± 6.0 cm³. The PTV derived from PSMA PET/CT encompassed 62% ± 27% of the GTV-MRI, with 44.4% of patients having the PTV covering 100% of the GTV-MRI. Conversely, the PTV based on GTV-MRI covered 50% ± 31% (mean ± SD) of the GTV-PET. Conclusions: 68Ga-PSMA PET/CT and mpMRI demonstrated consistent outcomes in 47% of patients (40%-54% of lesions). Notably, the GTV-PET was larger than the GTV-MRI, indicating a potential role for 68Ga-PSMA PET/CT in radiation therapy planning for targeted radiation delivery to PCa.
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spelling doaj-art-36ecedacc75c418191d02ef1cc8dc8642025-08-20T02:39:28ZengElsevierAdvances in Radiation Oncology2452-10942025-08-0110810182110.1016/j.adro.2025.101821Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate CancerHamed Bagheri, PhD0Seied Rabi Mahdavi, PhD1Parham Geramifar, PhD2Ali Neshasteh-Riz, PhD3Masoumeh Sajadi-Rad, MD4Habibollah Dadgar, PhD5Hossein Arabi, PhD6Habib Zaidi, PhD7Radiation Biology Research Center, Iran University of Medical Sciences (IUMS), Tehran, IranDepartment of Medical Physics, Radiation Biology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran; Corresponding authors: Seied Rabi Mahdavi, PhDDepartment of Nuclear Medicine, School of Medicine, Shariati Hospital, Tehran, IranRadiation Biology Research Center, Iran University of Medical Sciences (IUMS), Tehran, IranRadiation Biology Research Center, Iran University of Medical Sciences (IUMS), Tehran, IranNuclear Medicine and Molecular Imaging Department, Imam Reza Research Center, RAZAVI Hospital, Mashhad, IranDivision of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, SwitzerlandDivision of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark; University Research and Innovation Center, Óbuda University, Budapest, Hungary; Habib Zaidi, PhDPurpose: Magnetic resonance imaging (MRI) with multiparametric assessment is a cornerstone in radiation therapy planning for primary prostate cancer (PCa), offering the potential for focal dose escalation to dominant intraprostatic lesions to enhance PCa management. The prostate-specific membrane antigen (PSMA), which is frequently overexpressed in PCa, has led to the development of 68Ga-labeled PSMA inhibitors for positron emission tomography (PET)/computed tomography (CT), showing promising results in PCa detection. This study aimed to conduct a comparative analysis of 68Ga-PSMA PET/CT and multiparametric MRI (mpMRI) in delineating the gross tumor volume (GTV) in PCa. Methods and Materials: A retrospective analysis was performed on 25 PCa patients who underwent 68Ga-PSMA PET/CT and mpMRI at 2 distinct centers. The GTVs were delineated on MRI (GTV-MRI) by 2 nuclear medicine physicians and 1 radiation oncologist independently, while the GTVs based on PET/CT (GTV-PET) were outlined by 2 nuclear medicine physicians. The laterality (left, right, and bilateral) prostate lobes on mpMRI and PET/CT was assessed. To account for registration uncertainties, both GTV-PET and GTV-MRI were expanded isotropically by 5 mm to form the planning target volume (PTV), and the overlap between specific PTVs and their corresponding GTVs was quantified. Results: The average ± SD GTV-MRI and GTV-PET were 5.468 ± 11.6 cm³ and 11.136 ± 14.3 cm³, respectively, with the GTV-PET being significantly larger than the GTV-MRI (P = .003). GTV-MRI exhibited an intersection with GTV-PET of 3.5 ± 6.0 cm³. The PTV derived from PSMA PET/CT encompassed 62% ± 27% of the GTV-MRI, with 44.4% of patients having the PTV covering 100% of the GTV-MRI. Conversely, the PTV based on GTV-MRI covered 50% ± 31% (mean ± SD) of the GTV-PET. Conclusions: 68Ga-PSMA PET/CT and mpMRI demonstrated consistent outcomes in 47% of patients (40%-54% of lesions). Notably, the GTV-PET was larger than the GTV-MRI, indicating a potential role for 68Ga-PSMA PET/CT in radiation therapy planning for targeted radiation delivery to PCa.http://www.sciencedirect.com/science/article/pii/S2452109425001083
spellingShingle Hamed Bagheri, PhD
Seied Rabi Mahdavi, PhD
Parham Geramifar, PhD
Ali Neshasteh-Riz, PhD
Masoumeh Sajadi-Rad, MD
Habibollah Dadgar, PhD
Hossein Arabi, PhD
Habib Zaidi, PhD
Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
Advances in Radiation Oncology
title Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
title_full Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
title_fullStr Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
title_full_unstemmed Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
title_short Comparative Analysis of 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for Gross Tumor Volume Delineation in Radiation Therapy Planning of Prostate Cancer
title_sort comparative analysis of 68ga prostate specific membrane antigen positron emission tomography computed tomography and multiparametric magnetic resonance imaging for gross tumor volume delineation in radiation therapy planning of prostate cancer
url http://www.sciencedirect.com/science/article/pii/S2452109425001083
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