Hybrid imaging with [68Ga]PSMA-11 PET-CT and PET-MRI in biochemically recurrent prostate cancer.

AIM: To compare [68Ga]PSMA-11 PET-CT, [68Ga]PSMA-11 PET-MRI and MRI in a cohort of prostate cancer (PCa) patients in biochemical recurrence after initial curative therapy. MATERIALS AND METHODS: Fifty-three patients with biochemically recurrent PCa underwent whole-body [68Ga]PSMA-11 PET-CT 1 hour post-injection (p.i.) followed by [68Ga]PSMA-11 PET-MRI 2.5 hours p.i., including a multiparametric MRI pelvic protocol examination. Imaging data analysis consisted of visual (qualitative) evaluation of the PET-CT, PET-MRI and MRI scans, as well as semi-quantitative and quantitative analyses of the PET and MRI data, including calculation of the parameters standardized uptake value (SUV) and apparent diffusion coefficient (ADC) derived from the PCa lesions. Association analysis was performed between imaging and clinical data, including PSA level and Gleason score. The results were considered significant for p-values less than 0.05 (p < 0.05). RESULTS: The hybrid imaging modalities [68Ga]PSMA-11 PET-CT and PET-MRI were positive in more patients than MRI alone. In particular, PET-CT detected lesions suggestive of PCa relapse in 34/53 (64.2%), PET-MRI in 36/53 (67.9%) and MRI in 23/53 patients (43.4%). While no significant differences in lesion detection rate were observed between PET-CT and PET-MRI, the latter was particularly efficient in detection of local recurrences in the prostate bed mainly due to the contribution of the MRI part of the modality. Association analysis revealed a statistically significant increase in the probability of a positive scan with increasing PSA levels for all imaging modalities. Accordingly, there was no significant association between scan positivity rate and Gleason score for any imaging modality. No significant correlation was observed between SUV and ADC values in lymph node metastases. CONCLUSION: [68Ga]PSMA-11 PET-CT and PET-MRI provide equally good detection rates for PCa recurrence, both outperforming stand-alone MRI.

[Clinical forensic imaging. Detection and documentation of internal injuries in living victims of violence]. / Klinisch-forensische Bildgebung. Erfassung und Dokumentation innerer Verletzungsbefunde bei lebenden Gewaltopfern.

External examination of the body surface with documentation of all visible findings can still be regarded as the status quo of clinical forensic injury assessment. It is obvious that internal findings cannot be detected using this technique. For obtaining such findings accessible well-established radiological techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI) should be used. Especially MRI with no damaging radiation exposure for the examined person allows the detection of internal soft tissue and organ damage and offers a great potential regarding new techniques for allowing insights into tissue composition and function. Furthermore, imaging data collected in clinical institutions before the patient was transferred to the department of legal medicine will play a major role in the future. Although these data were obtained based on a different approach, they provide excellent and recent information on injuries in the respective (current) case und can therefore be of high value for the forensic expertise.