Reducing False-Positives Due to Urinary Stagnation in the Prostatic Urethra on 18F-DCFPyL PSMA PET/CT With MRI

作者：David G. Gelikman, Esther Mena, Liza Lindenberg, William S. Azar, Nityam Rathi, Enis C. Yılmaz, Stephanie A. Harmon, Kyle C. Schuppe, Jessica Hsueh, Hannah Huth, Bradford J. Wood, Sandeep Gurram, Peter L. Choyke, Peter A. Pinto, Barış Türkbey · 发表于：Clinical Nuclear Medicine · 年份：2024 · DOI：10.1097/rlu.0000000000005220 · 被引用次数：5 · 研究领域：Prostate Cancer Treatment and Research、Urinary Bladder and Prostate Research、Prostate Cancer Diagnosis and Treatment

PURPOSE: Prostate-specific membrane antigen (PSMA)-targeting PET radiotracers reveal physiologic uptake in the urinary system, potentially misrepresenting activity in the prostatic urethra as an intraprostatic lesion. This study examined the correlation between midline 18 F-DCFPyL activity in the prostate and hyperintensity on T2-weighted (T2W) MRI as an indication of retained urine in the prostatic urethra. PATIENTS AND METHODS: Eighty-five patients who underwent both 18 F-DCFPyL PSMA PET/CT and prostate MRI between July 2017 and September 2023 were retrospectively analyzed for midline radiotracer activity and retained urine on postvoid T2W MRIs. Fisher's exact tests and unpaired t tests were used to compare residual urine presence and prostatic urethra measurements between patients with and without midline radiotracer activity. The influence of anatomical factors including prostate volume and urethral curvature on urinary stagnation was also explored. RESULTS: Midline activity on PSMA PET imaging was seen in 14 patients included in the case group, whereas the remaining 71 with no midline activity constituted the control group. A total of 71.4% (10/14) and 29.6% (21/71) of patients in the case and control groups had urethral hyperintensity on T2W MRI, respectively ( P < 0.01). Patients in the case group had significantly larger mean urethral dimensions, larger prostate volumes, and higher incidence of severe urethral curvature compared with the controls. CONCLUSIONS: Stagnat...