Improved performance of SPECT-CT In-111 capromab pendetide by correlation with diffusion-weighted magnetic resonance imaging for identifying metastatic pelvic lymphadenopathy in prostate cancer

World J Urol. 2013 Dec;31(6):1327-32. doi: 10.1007/s00345-013-1079-2. Epub 2013 Apr 18.

Abstract

Purpose: To preliminarily evaluate the potential for an improvement in diagnostic performance by a combined interpretation of In-111 capromab pendetide single photon emission computed tomography (SPECT) including computed tomography (CT) image fusion with magnetic resonance diffusion-weighted imaging (MR-DWI) for identifying prostate cancer in pelvic lymph nodes thru correlation with histopathology.

Materials and methods: This institutional approved, retrospective study identified patients with available histopathology of lymph nodes removed at the time of radical prostatectomy and who had undergone staging with In-111 capromab pendetide SPECT-CT and/or pelvic MRI (including DWI). The performance of In-111 capromab pendetide SPECT for identifying malignant lymph nodes was assessed. Subsequently, a combined reading of In-111 capromab pendetide SPECT and prostate MRI with DWI was performed and the performance assessed.

Results: 18 patients underwent In-111 capromab pendetide SPECT-CT. Of these, 12 patients had also undergone imaging with MR-DWI. In-111 capromab pendetide SPECT-CT had a sensitivity of 40.0% and specificity of 96.7% for identification of malignant lymph nodes. However, In-111 capromab pendetide SPECT-CT combined with MRI with DWI had a sensitivity of 88.9% and specificity of 98.5%.

Conclusions: The addition of MR-DWI to the interpretation of In-111 capromab pendetide SPECT-CT may increase the sensitivity for detecting malignant lymph nodes in prostate cancer. Future prospective evaluation of combined In-111 capromab pendetide SPECT-CT and MR-DWI is indicated and may improve clinical evaluation of nodal disease in prostate cancer.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Antibodies, Monoclonal*
  • Diffusion Magnetic Resonance Imaging*
  • Humans
  • Indium Radioisotopes*
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnosis
  • Male
  • Middle Aged
  • Pelvic Neoplasms / diagnosis*
  • Pelvic Neoplasms / secondary
  • Prospective Studies
  • Prostate / diagnostic imaging
  • Prostate / pathology
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / pathology*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, X-Ray Computed / methods*

Substances

  • Antibodies, Monoclonal
  • Indium Radioisotopes
  • Capromab Pendetide