“Seeing Is Believing”: Additive Utility of 68Ga-PSMA-11 PET/CT in Prostate Cancer Diagnosis
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摘要Widespread adoption of mpMRI has led to a decrease in the number of patients requiring prostate biopsies. 68Ga-PSMA-11 PET/CT has demonstrated added benefits in identifying csPCa. Integrating the use of these imaging techniques may hold promise for predicting the presence of csPCa without invasive biopsy. A retrospective analysis of 42 consecutive patients who underwent mpMRI, 68Ga-PSMA-11 PET/CT, prostatic biopsy, and radical prostatectomy (RP) was carried out. A lesion-based model (n = 122) using prostatectomy histopathology as reference standard was used to analyze the accuracy of 68Ga-PSMA-11 PET/CT, mpMRI alone, and both in combination to identify ISUP-grade group ≥ 2 lesions. 68Ga-PSMA-11 PET/CT demonstrated greater specificity and positive predictive value (PPV), with values of 73.3% (vs. 40.0%) and 90.1% (vs. 82.2%), while the mpMRI Prostate Imaging Reporting and Data System (PI-RADS) 4–5 had better sensitivity and negative predictive value (NPV): 90.2% (vs. 78.5%) and 57.1% (vs. 52.4%), respectively. When used in combination, the sensitivity, specificity, PPV, and NPV were 74.2%, 83.3%, 93.2%, and 51.0%, respectively. Subgroup analysis of PI-RADS 3, 4, and 5 lesions was carried out. For PI-RADS 3 lesions, 68Ga-PSMA-11 PET/CT demonstrated a NPV of 77.8%. For PI-RADS 4–5 lesions, 68Ga-PSMA-11 PET/CT achieved PPV values of 82.1% and 100%, respectively, with an NPV of 100% in PI-RADS 5 lesions. A combination of 68Ga-PSMA-11 PET/CT and mpMRI improved the radiological diagnosis of csPCa. This suggests that avoidance of prostate biopsy prior to RP may represent a valid option in a selected subgroup of high-risk patients with a high suspicion of csPCa on mpMRI and 68Ga-PSMA-11 PET/CT.
出版社接受日期02.05.2024
著者Chin J., Tan Y.G., Lee A., Ng T.K., Shi R., Tang C.Y.L., Thang S.P., Tuan J.K.L., Cheng C.W.S., Tay K.J., Ho H.S.S., Wang H.J., Chiu P.K.F., Teoh J.Y.C., Lam W.W.C., Law Y.M., Yuen J.S.P., Chen K.
期刊名稱Cancers
出版年份2024
月份5
日期5
卷號16
期次9
出版社Multidisciplinary Digital Publishing Institute (MDPI)
文章號碼1777
電子國際標準期刊號2072-6694
語言英式英語
關鍵詞biopsy, mpMRI, prostate cancer diagnosis, PSMA PET
