An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis

<b>Background/Objectives</b>: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). <b>Met...

Full description

Saved in:
Bibliographic Details
Main Authors: Paola Arena, Vittorio Fasulo, Fabrizia Gelardi, Nicola Frego, Jelena Jandric, Davide Maffei, Pier Paolo Avolio, Marco Paciotti, Giuseppe Chiarelli, Fabio De Carne, Filippo Dagnino, Andrea Piccolini, Egesta Lopci, Rodolfo Hurle, Alberto Saita, Arturo Chiti, Massimo Lazzeri, Laura Evangelista, Nicolò Maria Buffi, Paolo Casale, Giovanni Lughezzani
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/15/12/1492
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849432936214953984
author Paola Arena
Vittorio Fasulo
Fabrizia Gelardi
Nicola Frego
Jelena Jandric
Davide Maffei
Pier Paolo Avolio
Marco Paciotti
Giuseppe Chiarelli
Fabio De Carne
Filippo Dagnino
Andrea Piccolini
Egesta Lopci
Rodolfo Hurle
Alberto Saita
Arturo Chiti
Massimo Lazzeri
Laura Evangelista
Nicolò Maria Buffi
Paolo Casale
Giovanni Lughezzani
author_facet Paola Arena
Vittorio Fasulo
Fabrizia Gelardi
Nicola Frego
Jelena Jandric
Davide Maffei
Pier Paolo Avolio
Marco Paciotti
Giuseppe Chiarelli
Fabio De Carne
Filippo Dagnino
Andrea Piccolini
Egesta Lopci
Rodolfo Hurle
Alberto Saita
Arturo Chiti
Massimo Lazzeri
Laura Evangelista
Nicolò Maria Buffi
Paolo Casale
Giovanni Lughezzani
author_sort Paola Arena
collection DOAJ
description <b>Background/Objectives</b>: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). <b>Methods</b>: We retrospectively reviewed prospectively collected data on patients referred to our hospital from October 2020 to January 2023. We included all patients who underwent [68Ga]Ga-PSMA-11 or [18F]F-PSMA-1007 PET/CT for primary staging and subsequently had RARP with concomitant LND. The maximum standard uptake value (SUVmax) for lymph nodes (LNs) and the SUV node-to-background ratio were reported. Two different cut-off values for the SUV node-to-background ratio (i.e., ≥2 vs. <2 and ≥15.5 vs. <15.5) were used to evaluate the diagnostic performance of both tracers. The first cut-off was empirically chosen, while the second was based on Liu’s method. <b>Results</b>: A total of 156 patients were included (median age: 67 years). Among them, 83 underwent [68Ga]Ga-PSMA-11 and 73 underwent [18F]F-PSMA-1007 PET/CT. Suspicious lymph nodes were identified in 21 patients (13.5%). Pathological nodal involvement (pN1) was confirmed in 25 cases (16%). Of the 21 patients with suspicious pathological lymph nodes on PSMA PET/CT, 9 (42.9%) had positive nodes on the final pathology report. With an SUV node-to-background ratio cut-off of ≥2, [68Ga]Ga-PSMA-11 showed 37.5% sensitivity (SE) and 98.5% specificity(SP), while [18F]F-PSMA-1007 demonstrated 33.3% SE and 100% SP. Using the ≥15.5 cut-off, SE and SP were 31.3% and 100% for [68Ga]Ga-PSMA-11 and 11.1% and 100% for [18F]F-PSMA-1007, respectively. <b>Conclusions</b>: [18F]F-PSMA-1007 PET/CT showed, even if not statistically significantly, slightly lower SE and higher SP for nodal staging compared to [68Ga]Ga-PSMA-11 PET/CT, irrespective of the SUV ratio used.
format Article
id doaj-art-3b6df505ae3644d5a82194c4aa744fae
institution Kabale University
issn 2075-4418
language English
publishDate 2025-06-01
publisher MDPI AG
record_format Article
series Diagnostics
spelling doaj-art-3b6df505ae3644d5a82194c4aa744fae2025-08-20T03:27:14ZengMDPI AGDiagnostics2075-44182025-06-011512149210.3390/diagnostics15121492An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional AnalysisPaola Arena0Vittorio Fasulo1Fabrizia Gelardi2Nicola Frego3Jelena Jandric4Davide Maffei5Pier Paolo Avolio6Marco Paciotti7Giuseppe Chiarelli8Fabio De Carne9Filippo Dagnino10Andrea Piccolini11Egesta Lopci12Rodolfo Hurle13Alberto Saita14Arturo Chiti15Massimo Lazzeri16Laura Evangelista17Nicolò Maria Buffi18Paolo Casale19Giovanni Lughezzani20Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, ItalyIRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, Italy<b>Background/Objectives</b>: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). <b>Methods</b>: We retrospectively reviewed prospectively collected data on patients referred to our hospital from October 2020 to January 2023. We included all patients who underwent [68Ga]Ga-PSMA-11 or [18F]F-PSMA-1007 PET/CT for primary staging and subsequently had RARP with concomitant LND. The maximum standard uptake value (SUVmax) for lymph nodes (LNs) and the SUV node-to-background ratio were reported. Two different cut-off values for the SUV node-to-background ratio (i.e., ≥2 vs. <2 and ≥15.5 vs. <15.5) were used to evaluate the diagnostic performance of both tracers. The first cut-off was empirically chosen, while the second was based on Liu’s method. <b>Results</b>: A total of 156 patients were included (median age: 67 years). Among them, 83 underwent [68Ga]Ga-PSMA-11 and 73 underwent [18F]F-PSMA-1007 PET/CT. Suspicious lymph nodes were identified in 21 patients (13.5%). Pathological nodal involvement (pN1) was confirmed in 25 cases (16%). Of the 21 patients with suspicious pathological lymph nodes on PSMA PET/CT, 9 (42.9%) had positive nodes on the final pathology report. With an SUV node-to-background ratio cut-off of ≥2, [68Ga]Ga-PSMA-11 showed 37.5% sensitivity (SE) and 98.5% specificity(SP), while [18F]F-PSMA-1007 demonstrated 33.3% SE and 100% SP. Using the ≥15.5 cut-off, SE and SP were 31.3% and 100% for [68Ga]Ga-PSMA-11 and 11.1% and 100% for [18F]F-PSMA-1007, respectively. <b>Conclusions</b>: [18F]F-PSMA-1007 PET/CT showed, even if not statistically significantly, slightly lower SE and higher SP for nodal staging compared to [68Ga]Ga-PSMA-11 PET/CT, irrespective of the SUV ratio used.https://www.mdpi.com/2075-4418/15/12/1492PSMAprostate cancernodal staging68Ga18Fprostatectomy
spellingShingle Paola Arena
Vittorio Fasulo
Fabrizia Gelardi
Nicola Frego
Jelena Jandric
Davide Maffei
Pier Paolo Avolio
Marco Paciotti
Giuseppe Chiarelli
Fabio De Carne
Filippo Dagnino
Andrea Piccolini
Egesta Lopci
Rodolfo Hurle
Alberto Saita
Arturo Chiti
Massimo Lazzeri
Laura Evangelista
Nicolò Maria Buffi
Paolo Casale
Giovanni Lughezzani
An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
Diagnostics
PSMA
prostate cancer
nodal staging
68Ga
18F
prostatectomy
title An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
title_full An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
title_fullStr An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
title_full_unstemmed An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
title_short An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis
title_sort evaluation of the diagnostic accuracy of 68ga ga psma 11 vs 18f f psma 1007 pet ct for lymph node staging in patient candidates for radical prostatectomy and lymph node dissection a single institutional analysis
topic PSMA
prostate cancer
nodal staging
68Ga
18F
prostatectomy
url https://www.mdpi.com/2075-4418/15/12/1492
work_keys_str_mv AT paolaarena anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT vittoriofasulo anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT fabriziagelardi anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT nicolafrego anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT jelenajandric anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT davidemaffei anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT pierpaoloavolio anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT marcopaciotti anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT giuseppechiarelli anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT fabiodecarne anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT filippodagnino anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT andreapiccolini anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT egestalopci anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT rodolfohurle anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT albertosaita anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT arturochiti anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT massimolazzeri anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT lauraevangelista anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT nicolomariabuffi anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT paolocasale anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT giovannilughezzani anevaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT paolaarena evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT vittoriofasulo evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT fabriziagelardi evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT nicolafrego evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT jelenajandric evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT davidemaffei evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT pierpaoloavolio evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT marcopaciotti evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT giuseppechiarelli evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT fabiodecarne evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT filippodagnino evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT andreapiccolini evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT egestalopci evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT rodolfohurle evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT albertosaita evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT arturochiti evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT massimolazzeri evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT lauraevangelista evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT nicolomariabuffi evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT paolocasale evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis
AT giovannilughezzani evaluationofthediagnosticaccuracyof68gagapsma11vs18ffpsma1007petctforlymphnodestaginginpatientcandidatesforradicalprostatectomyandlymphnodedissectionasingleinstitutionalanalysis