Liang Luo, Ruiyan Wang, Lu Bai, Jin Shang, Xinyi Wang, Ruxi Chang, Weixuan Dong, Yang Li, Yan Li, Hua Liang, Hongjun Xie, Xiaoyi Duan
{"title":"The accuracy of fluorine 18-labelled prostate-specific membrane antigen PET/CT and MRI for diagnosis of prostate cancer in PSA grey zone.","authors":"Liang Luo, Ruiyan Wang, Lu Bai, Jin Shang, Xinyi Wang, Ruxi Chang, Weixuan Dong, Yang Li, Yan Li, Hua Liang, Hongjun Xie, Xiaoyi Duan","doi":"10.1038/s41416-024-02934-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The diagnostic utility of prostate biopsy is limited for prostate cancer (PCa) in the prostate-specific antigen (PSA) grey zone. This study aims to evaluate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for PSA grey zone PCa and clinically significant PCa (csPCa).</p><p><strong>Methods: </strong>A total of 82 patients with PSA levels ranging from 4 to 10 ng/mL who underwent <sup>18</sup>F-PSMA-1007 PET/CT, mpMRI, and prostate biopsy were prospectively enrolled. For <sup>18</sup>F-PSMA-1007 PET/CT and mpMRI in detecting PCa and csPCa, sensitivity, specificity, and area under the curve (AUC) were assessed using biopsy histology as the standard.</p><p><strong>Results: </strong><sup>18</sup>F-PSMA-1007 PET/CT demonstrated better diagnostic performance for PCa than mpMRI (AUC 0.81 vs. 0.63, P = 0.02). 11.0% of patients with PI-RADS 3-5 had no PCa on biopsy, of whom 77.8% were correctly differentiated by <sup>18</sup>F-PSMA-1007 PET/CT. Combined <sup>18</sup>F-PSMA-1007 PET/CT + mpMRI improved sensitivity (92.5% vs. 73.6%) and negative predictive value (NPV, 78.9% vs. 53.3%) compared with mpMRI alone.</p><p><strong>Conclusions: </strong><sup>18</sup>F-PSMA-1007 PET/CT outperformed mpMRI for detecting PCa in the grey zone level of PSA. <sup>18</sup>F-PSMA-1007 PET/CT in combination with mpMRI has additional improvement in sensitivity and NPV for csPCa detection.</p><p><strong>Clinical trial registration: </strong>NCT05958004, 2024-07.</p>","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.4000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41416-024-02934-x","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The diagnostic utility of prostate biopsy is limited for prostate cancer (PCa) in the prostate-specific antigen (PSA) grey zone. This study aims to evaluate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for PSA grey zone PCa and clinically significant PCa (csPCa).
Methods: A total of 82 patients with PSA levels ranging from 4 to 10 ng/mL who underwent 18F-PSMA-1007 PET/CT, mpMRI, and prostate biopsy were prospectively enrolled. For 18F-PSMA-1007 PET/CT and mpMRI in detecting PCa and csPCa, sensitivity, specificity, and area under the curve (AUC) were assessed using biopsy histology as the standard.
Results: 18F-PSMA-1007 PET/CT demonstrated better diagnostic performance for PCa than mpMRI (AUC 0.81 vs. 0.63, P = 0.02). 11.0% of patients with PI-RADS 3-5 had no PCa on biopsy, of whom 77.8% were correctly differentiated by 18F-PSMA-1007 PET/CT. Combined 18F-PSMA-1007 PET/CT + mpMRI improved sensitivity (92.5% vs. 73.6%) and negative predictive value (NPV, 78.9% vs. 53.3%) compared with mpMRI alone.
Conclusions: 18F-PSMA-1007 PET/CT outperformed mpMRI for detecting PCa in the grey zone level of PSA. 18F-PSMA-1007 PET/CT in combination with mpMRI has additional improvement in sensitivity and NPV for csPCa detection.
期刊介绍:
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.