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Volume 70, Issue 5, Pages (November 2016)

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1 Volume 70, Issue 5, Pages 829-836 (November 2016)
Simultaneous 68Ga-PSMA HBED-CC PET/MRI Improves the Localization of Primary Prostate Cancer  Matthias Eiber, Gregor Weirich, Konstantin Holzapfel, Michael Souvatzoglou, Bernhard Haller, Isabel Rauscher, Ambros J. Beer, Hans- Jürgen Wester, Juergen Gschwend, Markus Schwaiger, Tobias Maurer  European Urology  Volume 70, Issue 5, Pages (November 2016) DOI: /j.eururo Copyright © 2016 European Association of Urology Terms and Conditions

2 Fig. 1 A 65-year-old patient with a biopsy-proven prostate cancer Gleason score of 6 and a prostate-specific antigen of 24.5 ng/ml. (A) Transverse T2-weighted images show considerable benign prostatic hyperplasia in the central zone presenting with one large and multiple surrounding small nodules. Prostate Imaging Reporting and Data System (PI-RADS) scoring using information from diffusion-weighted imaging (apparent diffusion coefficient map shown in B) and dynamic contrast-enhanced (enhancement curve in C) resulted in a PI-RADS scores of 2 for the right and left midgland sextants. Positron emission tomography (PET) and fused T2-weighted/PET images show intense focal uptake projecting on the right peripheral zone. Note that only slight diffuse uptake is present in the central gland. (D) In PET a score of 5 was given. (E) In the combined PET/magnetic resonance imaging (MRI), due to missing clearly suspicious findings on MRI, a score of 4 was given for the right midgland sextant. (F) Hematoxylin and eosin gross section histopathology shows an oval Gleason score 6 tumor focus in the right peripheral zone. Note that the different anteroposterior positive focus of the tumor nodus in imaging and histopathology is related to slightly different planes. European Urology  , DOI: ( /j.eururo ) Copyright © 2016 European Association of Urology Terms and Conditions

3 Fig. 2 A 67-year-old patient with a biopsy-proven prostate cancer Gleason score of 7a and a prostate-specific antigen of 5.4 ng/ml. (A, B) Transverse T2-weighted images of apical sextants show slightly hypointense signal with restricted diffusion in the apparent diffusion coefficient map but isointense impression in the b-value 800 s/mm2 in the transitional zone. (C) Dynamic contrast-enhanced curve exhibits pronounced enhancement with a type 2 curve pattern resulting in a Prostate Imaging Reporting and Data System score of 3. (D) Positron emission tomography (PET) and (E) fused T2-weighted/PET images show intense focal uptake projecting ventrally to the urethra. Due to the high intensity of gallium 68 (68Ga)-prostate-specific membrane antigen (PSMA) HBED-CC uptake both in PET and 68Ga-PSMA HBED-CC PET/MRI, a score of 5 was applied. (F) Hematoxylin and eosin gross section histopathology shows a corresponding tumor focus. European Urology  , DOI: ( /j.eururo ) Copyright © 2016 European Association of Urology Terms and Conditions

4 Fig. 3 Receiver operating characteristic curves for multiparametric magnetic resonance imaging (mpMRI), positron emission tomography (PET), and gallium 68 (68Ga)-prostate-specific membrane antigen (PSMA) HBED-CC PET/MRI on a sextant-based analysis. European Urology  , DOI: ( /j.eururo ) Copyright © 2016 European Association of Urology Terms and Conditions

5 European Urology 2016 70, 829-836DOI: (10.1016/j.eururo.2015.12.053)
Copyright © 2016 European Association of Urology Terms and Conditions

6 European Urology 2016 70, 829-836DOI: (10.1016/j.eururo.2015.12.053)
Copyright © 2016 European Association of Urology Terms and Conditions

7 European Urology 2016 70, 829-836DOI: (10.1016/j.eururo.2015.12.053)
Copyright © 2016 European Association of Urology Terms and Conditions

8 European Urology 2016 70, 829-836DOI: (10.1016/j.eururo.2015.12.053)
Copyright © 2016 European Association of Urology Terms and Conditions

9 European Urology 2016 70, 829-836DOI: (10.1016/j.eururo.2015.12.053)
Copyright © 2016 European Association of Urology Terms and Conditions


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