Comparison of multiparametric prostate MR imaging and Ga-68 PSMA PET-CT imaging in prostate cancer staging: Multiparametric MRI vs Ga-68 PSMA PET-CT in prostate cancer staging

Can Sicimli; Selahattin Bedir; Alev Çınar; Kemal Niyazi Arda

doi:10.28982/josam.8201

Authors

Can Sicimli Department of Urology, Ministry of Health Elmadag Dr. Hulusi Alatas State Hospital, Ankara, Turkey https://orcid.org/0000-0002-4967-014X
Selahattin Bedir Department of Urology, Health Science University Gulhane Research and Practice Hospital, Ankara, Turkey https://orcid.org/0000-0003-4999-9217
Alev Çınar Department of Nuclear Medicine, Ministry of Health Etlik City Hospital, Ankara, Turkey https://orcid.org/0000-0002-3426-2987
Kemal Niyazi Arda Department of Radiology, Health Science University Gulhane Research and Practice Hospital, Ankara, Turkey https://orcid.org/0000-0002-5404-4303

DOI:

https://doi.org/10.28982/josam.8201

Keywords:

MRI, Prostate Cancer, PSMA, Staging, Surgical Margin

Abstract

Background/Aim: Staging in prostate cancer is essential for determining the right treatment approach and its execution. This study assessed the staging effectiveness of multiparametric prostate magnetic resonance imaging (MpMRI) compared to prostate-specific membrane antigen (PSMA) positron emission tomography – computed tomography (PET-CT) and examined the preoperative information that they provide.

Methods: We collected data from patients diagnosed with prostate cancer who visited our clinic between June 2020 and November 2022. The results from MpMRI performed prior to biopsy were compared to those from PSMA PET-CT conducted after diagnosis, alongside the outcomes of pathological evaluations.

Results: There was no significant correlation between MpMRI and PSMA PET-CT findings and the final pathology results regarding extraprostatic extension. However, both imaging techniques showed a significant correlation with the final pathology in evaluating pelvic lymph-node metastasis and seminal vesicle invasion. In terms of lesion localization, no significant correlation was found between the final site of the pathological lesion and MpMRI, while a significant correlation was noted with PSMA PET-CT. Patients with positive surgical margins had significantly elevated serum PSA levels, size of the index lesion identified in MpMRI, and maximum standardized uptake values (SUV max) of PSMA.

Conclusion: Although both imaging methods offer important staging insights, further research is needed to clarify their respective limitations and benefits. In the future, these techniques may have additional roles in predicting surgical margin positivity before surgery.

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Author Biographies

Selahattin Bedir, Department of Urology, Health Science University Gulhane Research and Practice Hospital, Ankara, Turkey

Department of Urology, Health Science University Gulhane Research and Practice Hospital, Ankara, Turkey

Prof.

Alev Çınar, Department of Nuclear Medicine, Ministry of Health Etlik City Hospital, Ankara, Turkey

Department of Nuclear Medicine, Ministry of Health Etlik City Hospital, Ankara, Turkey

Assoc. Prof.

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