Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE): Proposed miTNM Classification for the Interpretation of PSMA-Ligand PET/CT

Matthias Eiber; Ken Herrmann; Jeremie Calais; Boris Hadaschik; Frederik L Giesel; Markus Hartenbach; Thomas Hope; Robert Reiter; Tobias Maurer; Wolfgang A Weber; Wolfgang P Fendler

doi:10.2967/jnumed.117.198119

Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE): Proposed miTNM Classification for the Interpretation of PSMA-Ligand PET/CT

J Nucl Med. 2018 Mar;59(3):469-478. doi: 10.2967/jnumed.117.198119. Epub 2017 Nov 9.

Authors

Matthias Eiber^{1

2}, Ken Herrmann^{1

3}, Jeremie Calais¹, Boris Hadaschik⁴, Frederik L Giesel⁵, Markus Hartenbach⁶, Thomas Hope⁷, Robert Reiter⁸, Tobias Maurer⁹, Wolfgang A Weber¹⁰, Wolfgang P Fendler^{11

12}

Affiliations

¹ Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
² Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
³ Klinik für Nuklearmedizin, Universitätsklinikum Essen, Essen, Germany.
⁴ Department of Urology, Universitätsklinikum Essen, Essen, Germany.
⁵ Department of Nuclear Medicine, University Hospital Heidelberg and DKFZ Heidelberg, Heidelberg, Germany.
⁶ Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
⁷ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
⁸ Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California.
⁹ Department of Urology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
¹⁰ Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York; and.
¹¹ Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California [email protected].
¹² Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.

PMID: 29123012
DOI: 10.2967/jnumed.117.198119

Abstract

Prostate-specific membrane antigen (PSMA)-ligand PET imaging provides unprecedented accuracy for whole-body staging of prostate cancer. As PSMA-ligand PET/CT is increasingly adopted in clinical trials and routine practice worldwide, a unified language for image reporting is urgently needed. We propose a molecular imaging TNM system (miTNM, version 1.0) as a standardized reporting framework for PSMA-ligand PET/CT or PET/MRI. miTNM is designed to organize findings in comprehensible categories to promote the exchange of information among physicians and institutions. Additionally, flowcharts integrating findings of PSMA-ligand PET and morphologic imaging have been designed to guide image interpretation. Specific applications, such as assessment of prognosis or impact on management, should be evaluated in future trials. miTNM is a living framework that evolves with clinical experience and scientific data.

Keywords: PROMISE; PSMA-ligand PET/CT; criteria; interpretation; miTNM; standardized evaluation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Gene Expression Regulation, Neoplastic
Glutamate Carboxypeptidase II / metabolism*
Humans
Image Interpretation, Computer-Assisted
Ligands
Male
Neoplasm Staging
Positron Emission Tomography Computed Tomography / standards*
Prostatic Neoplasms / diagnostic imaging*
Prostatic Neoplasms / metabolism*
Prostatic Neoplasms / pathology
Reference Standards

Substances

Ligands
Glutamate Carboxypeptidase II