Negative biopsy histology in men with PI-RADS score 5: is it useful PSMA PET/CT evaluation?

IF 1.4 Q3 UROLOGY & NEPHROLOGY

Archivio Italiano di Urologia e Andrologia Pub Date : 2024-06-27 DOI:10.4081/aiua.2024.12358

Pietro Pepe, Ludovica Pepe, Michele Pennisi

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Abstract

Introduction: To evaluate the accuracy of PSMA PET/CT in men with mpMRI PI-RADS score 5 negative biopsy histology.

Materials and methods: From January 2011 to January 2023, 180 men with PI-RADS score 5 underwent systematic plus mpMRI/TRUS biopsy; 25/180 (13.9%) patients had absence of cancer and six months from biopsy were submitted to: digital rectal examination, PSA and PSA density exams, mpMRI and 68GaPSMA PET/CT evaluation (standardized uptake value "SUVmax" was reported).

Results: In 24/25 (96%) patients PSA and PSA density significantly decreased, moreover, the PI-RADS score was downgraded resulting < 3; in addition, median SUVmax was 7.5. Only 1/25 (4%) man had an increased PSA value (from 10.5 to 31 ng/ml) with a confirmed PI-RADS score 5, SUVmax of 32 and repeated prostate biopsy demonstrating a Gleason score 9/ISUP Grade Group 5 PCa.

Conclusions: The strict follow up of men with PI-RADS score 5 and negative histology reduce the risk of missing csPCa especially if PSMA PET/CT evaluation is in agreement with downgrading of mpMRI (PI-RADS score < 3).

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PI-RADS 评分为 5 分的男性活检组织学阴性：PSMA PET/CT 评估有用吗？

简介：目的评估PSMA PET/CT在mpMRI PI-RADS评分5分活检组织学阴性男性中的准确性：2011年1月至2023年1月，180名PI-RADS评分为5分的男性接受了系统加mpMRI/TRUS活检；25/180（13.9%）名患者无癌症，在活检后6个月接受了数字直肠检查、PSA和PSA密度检查、mpMRI和68GaPSMA PET/CT评估（报告标准化摄取值 "SUVmax"）：结果：24/25（96%）名患者的 PSA 和 PSA 密度明显降低，PI-RADS 评分下降，结果小于 3；此外，中位 SUVmax 为 7.5。只有1/25（4%）的患者PSA值升高（从10.5到31纳克/毫升），PI-RADS评分确认为5分，SUVmax为32，重复前列腺活检显示为格里森评分9分/ISUP分级5级PCa：对 PI-RADS 评分为 5 分且组织学检查为阴性的男性进行严格随访可降低漏诊 csPCa 的风险，尤其是在 PSMA PET/CT 评估与 mpMRI 降级（PI-RADS 评分 < 3 分）一致的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archivio Italiano di Urologia e Andrologia UROLOGY & NEPHROLOGY-

CiteScore

2.10

自引率

35.70%

发文量

审稿时长

10 weeks