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Effect of Point-Spread Function Reconstruction for Indeterminate PSMA-RADS-3A Lesions on PSMA-Targeted PET Imaging of Men with Prostate Cancer
Open accessAbstract
Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is emerging as an important modality for imaging patients with prostate cancer (PCa). As with any imaging modality, indeterminate findings will arise. The PSMA reporting and data system (PSMA-RADS) version 1.0 codifies indeterminate soft tissue findings with the PSMA-RADS-3A moniker. We investigated the role of point-spread function (PSF) reconstructions on categorization of PSMA-RADS-3A lesions. Methods: This was a post hoc analysis of an institutional review board approved prospective trial. Around 60 min after the administration of 333 MBq (9 mCi) of PSMA-targeted 18F-DCFPyL, patients underwent PET/computed tomography (CT) acquisitions from the mid-thighs to the skull vertex. The PET data were reconstructed with and without PSF. Scans were categorized according to PSMA-RADS version 1.0, and all PSMA-RADS-3A lesions on non-PSF images were re-evaluated to determine if any could be re-categorized as PSMA-RADS-4. The maximum standardized uptake values (SUVs) of the lesions, mean SUVs of blood pool, and the ratios of those values were determined. Results: A total of 171 PSMA-RADS-3A lesions were identified in 30 patients for whom both PSF reconstructions and cross-sectional imaging follow-up were available. A total of 13/171 (7.6%) were re-categorized as PSMA-RADS-4 lesions with PSF reconstructions. A total of 112/171 (65.5%) were found on follow-up to be true positive for PCa, with all 13 of the re-categorized lesions being true positive on follow-up. The lesions that were re-categorized trended towards having higher SUVmax-lesion and SUVmax-lesion/SUVmean-blood-pool metrics, although these relationships were not statistically significant. Conclusions: The use of PSF reconstructions for 18F-DCFPyL PET can allow the appropriate re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. The routine use of PSF reconstructions for PSMA-targeted PET may be of value at those sites that utilize this technology.
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Standardized reading criteria do not negate the dissimilarities in the images obtained using different types of PET hardware and methods of image reconstruction, and both SiPM technology and PSF reconstruction have been found to result in systematically higher lesion conspicuity despite standardized reporting criteria (PSMA-RADS).
“However, standardized reading criteria do not negate the dissimilarities in the images obtained using different types of PET hardware and methods of image reconstruction, and both SiPM technology [79] and PSF reconstruction [225] have been found to result in systematically higher lesion conspicuity despite standardized reporting criteria (PSMA-RADS) [216].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [225]
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Influences on PET Quantification and Interpretation
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Metadata
- Authors
- Khatri, W., Chung, H. W., Werner, R. A., Leal, J. P., Pienta, K. J., Lodge, M. A., Gorin, M. A., Pomper, M. G., & Rowe, S. P.
- Affiliations
- Johns Hopkins University (US)
- Konkuk University (KR)
- Universitätsklinikum Würzburg (DE)
- University of Pittsburgh (US)
- Corresponding author
- Rowe, Steven P.
- ORCID
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2021-04-07
- Volume
- 11
- Issue
- 4
- Pages
- 665
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC8067967
- OpenAlex
- W3151521676
- Cited by
- 10
- References
- 19
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 1 · 2022: 4 · 2021: 1
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (CA134675, CA183031, CA184228, EB024495)
- Prostate Cancer Foundation (N/A)
- Progenics Phamaceuticals (N/A)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Urology › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- point spread function reconstruction, prostate cancer, 18F-DCFPyL, standardized uptake value, prostate-specific membrane antigen, PET/CT imaging, follow-up imaging
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