DANIELA ANDRADE FERRARO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
3 resultados
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- Infiltrative growth pattern of prostate cancer is associated with lower uptake on PSMA PET and reduced diffusion restriction on mpMRI(2022) LAUDICELLA, Riccardo; RUESCHOFF, Jan H.; FERRARO, Daniela A.; BRADA, Muriel D.; HAUSMANN, Daniel; MEBERT, Iliana; MAURER, Alexander; HERMANNS, Thomas; EBERLI, Daniel; RUPP, Niels J.; BURGER, Irene A.Purpose Recently, a significant association was shown between novel growth patterns on histopathology of prostate cancer (PCa) and prostate-specific membrane antigen (PSMA) uptake on [Ga-68]PSMA-PET. It is the aim of this study to evaluate the association between these growth patterns and ADC (mm(2)/1000 s) values in comparison to [Ga-68]PSMA uptake on PET/MRI. Methods We retrospectively evaluated patients who underwent [Ga-68]PSMA PET/MRI for staging or biopsy guidance, followed by radical prostatectomy at our institution between 07/2016 and 01/2020. The dominant lesion per patient was selected based on histopathology and correlated to PET/MRI in a multidisciplinary meeting, and quantified using SUVmax for PSMA uptake and ADC(mean) for diffusion restriction. PCa growth pattern was classified as expansive (EXP) or infiltrative (INF) according to its properties of forming a tumoral mass or infiltrating diffusely between benign glands by two independent pathologists. Furthermore, the corresponding WHO2016 ISUP tumor grade was evaluated. The t test was used to compare means, Pearson's test for categorical correlation, Cohen's kappa test for interrater agreement, and ROC curve to determine the best cutoff. Results Sixty-two patients were included (mean PSA 11.7 +/- 12.5). The interrater agreement between both pathologists was almost perfect with kappa=0.81. While 25 lesions had an EXP-growth with an ADC(mean) of 0.777 +/- 0.109, 37 showed an INF-growth with a significantly higher ADC(mean) of 1.079 +/- 0.262 (p < 0.001). We also observed a significant difference regarding PSMA SUVmax for the EXP-growth (19.2 +/- 10.9) versus the INF-growth (9.4 +/- 6.2, p < 0.001). Within the lesions encompassing the EXP- or the INF-growth, no significant correlation between the ISUP groups and ADC(mean) could be observed (p = 0.982 and p = 0.861, respectively). Conclusion PCa with INF-growth showed significantly lower SUVmax and higher ADC(mean) values compared to PCa with EXP-growth. Within the growth groups, ADC(mean) values were independent from ISUP grading.
conferenceObject Infiltrative growth-pattern on histopathology is associated with lower diffusion restriction: a potential reason for false-negative mpMRI in prostate cancer(2021) LAUDICELLA, R.; RUSCHOFF, J. H.; FERRARO, D. A.; HAUSMANN, D.; MEBERT, I.; MAURER, A.; HERMANNS, T.; EBERLI, D.; RUPP, N.; BURGER, I. A.- Development and external validation of a multivariable [68Ga]Ga-PSMA-11 PET-based prediction model for lymph node involvement in men with intermediate or high-risk prostate cancer(2023) MUEHLEMATTER, Urs J.; SCHWEIGER, Lilit; FERRARO, Daniela A.; HERMANNS, Thomas; MAURER, Tobias; HECK, Matthias M.; RUPP, Niels J.; EIBER, Matthias; RAUSCHER, Isabel; BURGER, Irene A.PurposeTo develop and evaluate a lymph node invasion (LNI) prediction model for men staged with [Ga-68]Ga-PSMA-11 PET.MethodsA consecutive sample of intermediate to high-risk prostate cancer (PCa) patients undergoing [Ga-68]Ga-PSMA-11 PET, extended pelvic lymph node dissection (ePLND), and radical prostatectomy (RP) at two tertiary referral centers were retrospectively identified. The training cohort comprised 173 patients (treated between 2013 and 2017), the validation cohort 90 patients (treated between 2016 and 2019). Three models for LNI prediction were developed and evaluated using cross-validation. Optimal risk-threshold was determined during model development. The best performing model was evaluated and compared to available conventional and multiparametric magnetic resonance imaging (mpMRI)-based prediction models using area under the receiver operating characteristic curves (AUC), calibration plots, and decision curve analysis (DCA).ResultsA combined model including prostate-specific antigen, biopsy Gleason grade group, [Ga-68]Ga Ga-PSMA-11 positive volume of the primary tumor, and the assessment of the [Ga-68]Ga-PSMA-11 report N-status yielded an AUC of 0.923 (95% CI 0.863-0.984) in the external validation. Using a cutoff of >= 17%, 44 (50%) ePLNDs would be spared and LNI missed in one patient (4.8%). Compared to conventional and MRI-based models, the proposed model showed similar calibration, higher AUC (0.923 (95% CI 0.863-0.984) vs. 0.700 (95% CI 0.548-0.852)-0.824 (95% CI 0.710-0.938)) and higher net benefit at DCA.ConclusionsOur results indicate that information from [Ga-68]Ga-PSMA-11 may improve LNI prediction in intermediate to high-risk PCa patients undergoing primary staging especially when combined with clinical parameters. For better LNI prediction, future research should investigate the combination of information from both PSMA PET and mpMRI for LNI prediction in PCa patients before RP.