ProstatePub Date : 2024-12-01Epub Date: 2024-09-01DOI: 10.1002/pros.24785
Fabian Falkenbach, Fatima Ahmad-Sterkau, Mykyta Kachanov, Dirk Beyersdorff, Daniel Koehler, Francesca Ambrosini, Gernot Ortner, Tobias Maurer, Markus Graefen, Lars Budäus
{"title":"Bimodal imaging: Detection rate of clinically significant prostate cancer is higher in MRI lesions visible to transrectal ultrasound.","authors":"Fabian Falkenbach, Fatima Ahmad-Sterkau, Mykyta Kachanov, Dirk Beyersdorff, Daniel Koehler, Francesca Ambrosini, Gernot Ortner, Tobias Maurer, Markus Graefen, Lars Budäus","doi":"10.1002/pros.24785","DOIUrl":"10.1002/pros.24785","url":null,"abstract":"<p><strong>Background: </strong>To explore the detection rates of clinically significant prostate cancer (csPCa; ISUP ≥2) in patients with a single MRI lesion that is visible or invisible on transrectal ultrasound (TRUS) during biopsy.</p><p><strong>Methods: </strong>Retrospective analyses of patients who underwent targeted and systematic biopsy of the prostate for one MRI-visible lesion (PI-RADS score ≥ 3) between 2017 and 2022. TRUS-visibility, PI-RADS score, and clinical parameters were recorded prospectively. Univariable and multivariable logistic regression models were used to identify predictors of csPCa.</p><p><strong>Results: </strong>277 consecutive patients with one MRI-visible lesion were identified. A correlating lesion on TRUS was present in 147/277 (53%). The median age, PSA level, and prostate volume were 68.0 years (IQR: 62.0-73.0), 7.3 ng/ml (IQR: 5.4-10.8) and 45.0 cc (IQR: 32.0-68.0), respectively. Baseline parameters were not significantly different between the two groups. CsPCa was detected in 59/130 (45%) without and in 102/147 (69%) patients with a corresponding TRUS lesion. In multivariable logistic regression analysis predicting csPCa, TRUS-visibility (OR: 2.13, CI: 1.14-4.03, p = 0.02) and PI-RADS score (PI-RADS 4: OR: 7.28, CI: 3.33-17.19; PI-RADS 5: OR: 13.39, CI: 5.27-36.83, p < 0.001) achieved independent predictor status.</p><p><strong>Conclusions: </strong>Bimodal-visible lesions more often harbored csPCa and were easier to target. TRUS-visibility of MRI lesions is an independent predictor of csPCa. Therefore, education in both modalities is essential. Despite MRI, the ultrasound should still be diligently examined.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1448-1455"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-08DOI: 10.1002/pros.24790
Breno Barros Alves, Pedro Gabrich, Luciano A Favorito
{"title":"Prospective results of the minimally invasive laser enucleation of the prostate (MiLEP).","authors":"Breno Barros Alves, Pedro Gabrich, Luciano A Favorito","doi":"10.1002/pros.24790","DOIUrl":"10.1002/pros.24790","url":null,"abstract":"<p><strong>Background: </strong>The objective of the present study is to prospectively analyze the prostate enucleation procedure with Holmium Laser using the minimally invasive technique (MiLEP), comparing the outcomes and their variables pre- and postoperatively.</p><p><strong>Methods: </strong>We studied men aged 40 years or over, with prostate volumes greater than or equal to 35 cm³ with lower urinary tract symptoms due to BPH. We performed flowmetry and administered the IPSS questionnaire before and 6 months after the MiLEP procedure. The patients were operated on with a 60 W Holmium Laser (Cyber-Ho Quanta System®) using 54 W of power (energy 1.8 J and frequency of 30 Hz). Enucleation was performed using the en bloc technique with early sphincter release. After enucleation, the tissue was morcellated using a 22 Fr morcescope (RZ-Medizintechnik GmbH, Tuttlingen, Germany) and Piranha (Richard Wolf) morcellator. The final Hemostasis after morcelation was made using laser with 30wW power, energy at 1,0 joules and frequency at 30 Hertz. Student's T test and Man-Whitney was used to statistical analysis (p < 0.05).</p><p><strong>Results: </strong>After selection we submitted 73 patients (mean age= 68.2 years) to MiLEP procedure with a follow up of 6 months. The prostate volume presented an average of 94.53 cm³ (65 to 112 cm³, SD = 5.363) preoperatively. The urinary continence rate after the procedure was greater than 95% after 1 week and 99% in the 1st month. All patients were continent after 6 months. The IPSS questionnaire before (mean = 21.18 points/SD = 6.557) and after (mean = 7.92 points/SD = 2.408) the MiLEP had statistical significance (p < 0.001). The flowmetry(ml/s) before (9.02/SD = 2.842) and after (21.07/SD = 6.228) the MiLEP had statistical significance (p < 0.001). The average time of the procedure was 78.5 min and the bladder catheter was removed after 18 h in mean. In 4 patients (5.8%) we observed hematuria and in 1 case (1.47%) the patient needs urinary catheterization.</p><p><strong>Conclusion: </strong>MiLEP is a safe and effective procedure, with significant improvement in urinary flow and symptoms in the short term. Although the results of this study were satisfactory and the urinary incontinence rate was lower compared to HoLEP data found in the literature, multicenter studies with longer follow-up are needed to confirm these findings.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1501-1505"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-22DOI: 10.1002/pros.24794
Xiangbin Kong, Zhilong Dong, Weiwei Hu, Jun Mi, Jie Xiao, Yiran Wang, Wenfang Chen, Zixu Pei, Zongyao Hao, Chaozhao Liang, Qi Wang, Zhiping Wang
{"title":"The role of gut microbiota involved in prostate microenvironment and symptoms improvement in chronic prostatitis/chronic pelvic pain syndrome patients treated with low-intensity extracorporeal shock wave.","authors":"Xiangbin Kong, Zhilong Dong, Weiwei Hu, Jun Mi, Jie Xiao, Yiran Wang, Wenfang Chen, Zixu Pei, Zongyao Hao, Chaozhao Liang, Qi Wang, Zhiping Wang","doi":"10.1002/pros.24794","DOIUrl":"10.1002/pros.24794","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity extracorporeal shockwave therapy (Li-ESWT) is emerging as a promising and safe treatment for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this study, we aimed to investigate the role of the gut microbiota involved in the prostate microenvironment and symptom improvement during the Li-ESWT for CP/CPPS patients.</p><p><strong>Methods: </strong>CP/CPPS patients not taking antibiotics or other treatments were included. NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5) were used to evaluate the effectiveness of Li-ESWT at the end of treatment. Visual analogue scale/score was used to evaluate the pain during procedure. Stool and semen samples were collected before and after Li-ESWT. Shotgun metagenomics analyzed gut microbiota, while ELISA and other diagnostic kits detected biochemical changes in seminal plasma.</p><p><strong>Result: </strong>Of the 60 enrolled patients, 52 completed treatment. Li-ESWT response rate was 78.8% (41/52) at end of treatment. Among responders, the subitems of the NIH-CPSI; IPSS; and IIEF-5 scores improved significantly, and the seminal plasma analysis showed decreased TNF-a and MDA levels and increased SOD and Zn<sup>2+</sup> levels posttreatment. Gut microbiome analysis indicated that posttreatment, both α and β diversity increased, and the abundance of certain specific species significantly increased. Fifty-eight pathways significantly enriched posttreatment, notably in branched-chain amino acid synthesis and butyrate synthesis. The abundance of several specific species was found to be significantly higher in non-responders than responders. Among responders, at the species level, some bacteria associated with NIH-CPSI and its subscales, IPSS, IIEF-5, and prostate microenvironment markers (TNF-a, MDA, Zn<sup>2+</sup>, and SOD) were identified.</p><p><strong>Conclusions: </strong>Our study demonstrates for the first time that Li-ESWT improves the prostate microenvironment and gut microbiota in CP/CPPS patients. Treatment nonresponse may be associated with a high abundance of specific pathogens before treatment. The gut microbiota could have a significant impact on Li-ESWT response and the prostate microenvironment.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1525-1536"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-08-18DOI: 10.1002/pros.24782
Chia-Ling Hsieh, Anh Duy Do, Chia-Yen Hsueh, Mafewu Olga Raboshakga, Tran Ngoc Thanh, Tran Tien Tai, Hsing-Jien Kung, Shian-Ying Sung
{"title":"L1CAM mediates neuroendocrine phenotype acquisition in prostate cancer cells.","authors":"Chia-Ling Hsieh, Anh Duy Do, Chia-Yen Hsueh, Mafewu Olga Raboshakga, Tran Ngoc Thanh, Tran Tien Tai, Hsing-Jien Kung, Shian-Ying Sung","doi":"10.1002/pros.24782","DOIUrl":"10.1002/pros.24782","url":null,"abstract":"<p><strong>Background: </strong>A specific type of prostate cancer (PC) that exhibits neuroendocrine (NE) differentiation is known as NEPC. NEPC has little to no response to androgen deprivation therapy and is associated with the development of metastatic castration-resistant PC (CRPC), which has an extremely poor prognosis. Our understanding of genetic drivers and activated pathways in NEPC is limited, which hinders precision medicine approaches. L1 cell adhesion molecule (L1CAM) is known to play an oncogenic role in metastatic cancers, including CRPC. However, the impact of L1CAM on NEPC progression remains elusive.</p><p><strong>Methods: </strong>L1CAM expression level was investigated using public gene expression databases of PC cohorts and patient-derived xenograft models. L1CAM knockdown was performed in different PC cells to study in vitro cell functions. A subline of CRPC cell line CWR22Rv1 was established after long-term exposure to abiraterone to induce NE differentiation. The androgen receptor-negative cell line PC3 was cultured under the tumor sphere-forming condition to enrich cancer stemness features. Several oxidative stress inducers were tested on PC cells to observe L1CAM-mediated gene expression and cell death.</p><p><strong>Results: </strong>L1CAM expression was remarkably high in NEPC compared to CRPC or adenocarcinoma tumors. L1CAM was also correlated with NE marker expressions and associated with the adenocarcinoma-to-NEPC progression in gene expression databases and CRPC cells with NE differentiation. L1CAM also promoted cancer stemness and NE phenotypes in PC3 cells under cancer stemness enrichment. L1CAM was also identified as a reactive oxygen species-induced gene, by which L1CAM counteracted CRPC cell death triggered by ionizing radiation.</p><p><strong>Conclusions: </strong>Our results unveiled a new role of L1CAM in the acquisition of the NE phenotype in PC, contributing to the NE differentiation-related therapeutic resistance of CRPC.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1434-1447"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-08-18DOI: 10.1002/pros.24781
Eric V Li, Matthew S Lee, Jenny Guo, Nicholas Dean, Sai Kumar, Xinlei Mi, Ruoji Zhou, Clayton Neill, Ximing Yang, Ashley E Ross, Amy E Krambeck
{"title":"Modern predictors and management of incidental prostate cancer at holmium enucleation of prostate.","authors":"Eric V Li, Matthew S Lee, Jenny Guo, Nicholas Dean, Sai Kumar, Xinlei Mi, Ruoji Zhou, Clayton Neill, Ximing Yang, Ashley E Ross, Amy E Krambeck","doi":"10.1002/pros.24781","DOIUrl":"10.1002/pros.24781","url":null,"abstract":"<p><strong>Background: </strong>To evaluate contemporary preoperative risk factors and subsequent postoperative management of incidental prostate cancer (iPCa) and incidental clinically significant prostate cancer (icsPCa, Grade Group [GG] ≥ 2 PCa).</p><p><strong>Methods: </strong>A retrospective cohort of 811 men undergoing Holmium enucleation of the prostate (HoLEP) (January 2021-July 2022) were identified. Advanced preoperative testing was defined as prostate health index (PHI), prostate MRI, and/or negative preoperative biopsy. Descriptive statistics (Whitney-Mann U test, Chi-squared test) and multivariable logistic regression were performed.</p><p><strong>Results: </strong>iPCa and icsPCa detection rates were 12.8% (104/811) and 4.4% (36/811), respectively. Advanced preoperative testing (406/811, 50%) was associated with younger age and higher (prostate specific antigen) PSA, prostate volume, and PSA density. On multivariable analysis, PHI ≥ 55 was associated with iPCa (OR 6.91, 95% CI 1.85-26.3, p = 0.004), and % free PSA (%fPSA) was associated with icsPCa (OR 0.83, 95% CI 0.67, 0.94, p = 0.01). GG1 disease comprised the majority of iPCa (65%, 68/104) with median 1% involvement. iPCa patients were followed with active surveillance (median follow up 9.3 months), with higher risk patients receiving prostate MRI and confirmatory biopsy. Three patients proceeded to radical prostatectomy or radiation.</p><p><strong>Conclusions: </strong>In the era of MRI and advanced biomarkers, the majority of iPCa following HoLEP is low volume GG1 suitable for active surveillance. A tentative follow-up strategy is proposed. Patients with PHI ≥ 55 or low %fPSA, even with negative prostate MRI, can consider preoperative prostate biopsy before HoLEP.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1427-1433"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-01DOI: 10.1002/pros.24786
Shan Lu, Michael Lamba, Jiang Wang, Zhongyun Dong
{"title":"Targeting proliferating cell nuclear antigen enhances ionizing radiation-induced cytotoxicity in prostate cancer cells.","authors":"Shan Lu, Michael Lamba, Jiang Wang, Zhongyun Dong","doi":"10.1002/pros.24786","DOIUrl":"10.1002/pros.24786","url":null,"abstract":"<p><strong>Background: </strong>Proliferating cell nuclear antigen (PCNA) is essential for DNA replication and repair, cell growth, and survival. PCNA also enhances androgen receptor (AR) signaling in prostate cancer (PC) cells. We identified a PCNA interaction protein (PIP) box at the N-terminal domain of AR and developed a small peptide PCNA inhibitor R9-AR-PIP containing AR PIP-box. We also identified a series of small molecule PCNA inhibitors (PCNA-Is) that bind directly to PCNA and interrupt PCNA functions. The present study investigated the effects of the PCNA inhibitors on the sensitivity of PC cells to X-ray radiation.</p><p><strong>Methods: </strong>The effects of targeting PCNA on radio sensitivity of PC cells were investigated in four lines of castration-resistant PC (CRPC) cells with different AR expression statuses. The cells were treated with the PCNA inhibitors and X-ray radiation alone or in combination. The effects of the treatment on expression of AR target genes, DNA damage response, DNA damage, homologous recombination repair (HRR), and cytotoxicity were evaluated.</p><p><strong>Results: </strong>We found that the androgen response element (ARE) occupancy of the DNA damage response gene PARP1 by AR is significantly attenuated by PCNA-I1S or R9-AR-PIP combined with X-ray radiation, while X-ray radiation alone does not enhance the ARE occupancy. PCNA-I1S or R9-AR-PIP alone significantly inhibits occupancy of the AR-occupied regions (AROR) in PRKDC and XRCC2 genes. R9-AR-PIP and PCNA-I1S inhibit expression of AR-Vs target gene cyclin A2 and show the additive effects with radiation in AR-positive CRPC cells. Targeting PCNA by PCNA-I1S and R9-AR-PIP downregulates expression of DNA damage response genes EXO1, Rad54L, Rad51, and/or PARP1 and shows the additive effects with radiation as compared with their respective controls in AR-positive CRPC LNCaP-AI, 22Rv1, and R1-D567 cells, but not in AR-negative PC-3 cells. R9-AR-PIP and PCNA-I1S elevate the levels of phospho-DNA-PKcs(S<sup>2056</sup>) and γH2AX, indicating DNA damage in response to radiation in AR-positive cells. The HRR is significantly attenuated by PCNA inhibitors PCNA-I1S, R9-AR-PIP, and T2AA in all four CRPC cells examined, and inhibited by Enzalutamide (Enz) only in 22RV1 cells. The cytotoxicity induced by X-ray radiation in androgen-dependent LNCaP cells is enhanced by Enz and a lower concentration of R9-AR-PIP in the colony formation assay. R9-AR-PIP at higher concentration reduces the colony formation and has an additive effect with X-ray radiation in all AR expressing cells, regardless of AR-FL and AR-Vs, but does not significantly alter the colony formation in AR-negative PC-3 cells. PCNA-I1S attenuates colony formation and has an additive effect with ionizing radiation in all four CRPC cells, regardless of AR expression status.</p><p><strong>Conclusion: </strong>These data provide a strong rationale for the therapy studies using PCNA-I1S or R9-AR-PIP in combinatio","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1456-1467"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic potential of SDHB mRNA contained in serum extracellular vesicles among patients with prostate cancer.","authors":"Taku Kato, Eiji Sugihara, Yuko Hata, Kyojiro Kawakami, Yasunori Fujita, Kosuke Mizutani, Tatsuya Ando, Yasuhiro Sakai, Kouhei Sakurai, Shohei Toyota, Hidetoshi Ehara, Masafumi Ito, Hiroyasu Ito","doi":"10.1002/pros.24792","DOIUrl":"10.1002/pros.24792","url":null,"abstract":"<p><strong>Background: </strong>Androgen receptor signaling inhibitors(ARSIs) have been used to treat patients with metastatic prostate cancer (PC) and castration-resistant prostate cancer (CRPC). In this study, we aimed to identify novel serum extracellular vesicle (EV)-based biomarkers to diagnose ARSI-resistance and therapeutic targets for ARSI-resistant CRPC.</p><p><strong>Methods: </strong>Total RNA contained in serum EVs from 5 cases of CRPC before ARSI treatment and after acquiring ARSI-resistance was subjected to RNA-sequencing. The expression changes of selected RNAs contained in EVs were confirmed in 48 cases of benign prostatic hyperplasia (BPH) and 107 PC using reverse transcription-quantitative PCR (RT-qPCR) and compared with tissue RNA expression using public datasets.</p><p><strong>Results: </strong>RNA-sequencing revealed that mitochondrial oxidative phosphorylation (OXPHOS)-related genes were increased in EVs after acquiring ARSI-resistance. Among them, RT-qPCR and datasets analysis demonstrated that SDHB mRNA was upregulated after acquiring ARSI-resistance in EVs and ARSI-exposed PC tissue compared to ARSI-naïve EVs and tissue, respectively. SDHB mRNA levels both in EVs and tissue were increased in localized PC compared with BPH and decreased in advanced PC. Tissue expression of SDHB mRNA was significantly correlated with those of other OXPHOS-related genes. SDHB mRNA in EVs (EV-SDHB) was elevated among 3 out of 7 ARSI-treating patients with stable PSA levels who later progressed to ARSI-resistant CRPC.</p><p><strong>Conclusions: </strong>The levels of OXPHOS-related mRNAs in EVs correlated with those in PC tissue, among which SDHB mRNA was found to be a novel biomarker to diagnose ARSI-resistance. EV-SDHB may be useful for early diagnosis of ARSI-resistance.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1515-1524"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-09DOI: 10.1002/pros.24780
Jorge D Oldan, Steven P Rowe, Jennifer A Schroeder
{"title":"Evaluation of online teaching modules for PSMA PET interpretation.","authors":"Jorge D Oldan, Steven P Rowe, Jennifer A Schroeder","doi":"10.1002/pros.24780","DOIUrl":"10.1002/pros.24780","url":null,"abstract":"<p><strong>Purpose: </strong>The proliferation of US FDA-approved prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging agents as a means to evaluate prostate cancer patients, and the expanding knowledge of interpretive pitfalls, has led to the generation of multiple online training modules geared toward the reading of each individual agent, each taking different approaches to criteria for interpretation, which may contribute to the variability of reporting in clinical practice.</p><p><strong>Materials and methods: </strong>The websites of the marketers of each FDA-approved agent [<sup>68</sup>Ga-PSMA-11 (Illuccix; Telix Pharmaceuticals), <sup>68</sup>Ga-PSMA-11 (Locametz; Novartis Pharmaceuticals), <sup>18</sup>F-rh-PSMA-7.3 (Posluma; Blue Earth Diagnostics)], and the website of the Society of Nuclear Medicine and Molecular Imaging [<sup>18</sup>F-DCFPyL (Pylarify)] were examined. All information pertaining to reader training, including videos, PDFs, and PowerPoint presentations, were reviewed.</p><p><strong>Results: </strong>Videos from each module covered interpretive approach and pitfalls and ranged in length from a total of 20 min up to 315 min. Each module provided a different approach to PSMA PET scan findings, and on a different number and breadth of interpretive tips and pitfalls (a total of approximately 12-30 in all).</p><p><strong>Conclusions: </strong>Each of the four PSMA PET reader training modules covered important interpretive pitfalls. The lengths of the video portions of each module varied considerably, suggesting variable investments in time necessary to complete each module. The differences in the modules could contribute to inconsistency among readers depending on which module(s) they may have completed and which radiotracer(s) they are using.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1419-1426"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-06DOI: 10.1002/pros.24787
Fabio Matrone, Fabio Del Ben, Marcella Montico, Elena Muraro, Agostino Steffan, Roberto Bortolus, Lucia Fratino, Alessandra Donofrio, Veronica Paduano, Martina Zanchetta, Matteo Turetta, Giulia Brisotto
{"title":"Prognostic value of circulating tumor cells in oligorecurrent hormone-sensitive prostate cancer patients undergoing stereotactic body radiation therapy.","authors":"Fabio Matrone, Fabio Del Ben, Marcella Montico, Elena Muraro, Agostino Steffan, Roberto Bortolus, Lucia Fratino, Alessandra Donofrio, Veronica Paduano, Martina Zanchetta, Matteo Turetta, Giulia Brisotto","doi":"10.1002/pros.24787","DOIUrl":"10.1002/pros.24787","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic body radiation therapy (SBRT) is an effective metastasis-directed therapy for managing oligometastatic prostate cancer patients. However, it lacks reliable biomarkers for risk stratification. Circulating Tumor Cells (CTC) show promise as minimally invasive prognostic indicators. This study evaluates the prognostic value of CTC in oligorecurrent hormone-sensitive prostate cancer (orHSPC).</p><p><strong>Methods: </strong>orHSPC patients with 1-3 nodal and/or bone metastases undergoing SBRT were enrolled (N = 35), with a median follow-up time of 42.1 months. CTC levels were measured at baseline (T0), 1 month (T1), and 3 months (T2) post-SBRT using a novel metabolism-based assay. These levels were correlated with clinical outcomes through Cox-regression and Kaplan-Meier analyses.</p><p><strong>Results: </strong>Median CTC counts were 5 at T0, 8 at T1, and 5 at T2 with no significant variation over time. Multivariate analysis identified high (≥5/7.5 mL) T0 CTC counts (HR 2.9, 95% CI 1.3-6.5, p = 0.01, median DPFS 29.7 vs. 14.0 months) and having more than one metastasis (HR 3.9, 95% CI 1.8-8.6, p < 0.005, median DPFS 34.1 vs. 10.7 months) as independent predictors of distant progression-free survival (DPFS). CTC assessment successfully stratified patients with a single metastasis (HR 3.4, 95% CI 1.1-10.2, p = 0.03, median DPFS 42.1 vs. 16.7 months), but not those with more than one metastasis. Additionally, a combined score based on CTC levels and the number of metastases effectively stratified patients.</p><p><strong>Conclusion: </strong>The study demonstrates that hypermetabolic CTC could enhance risk stratification in orHSPC patients undergoing SBRT, particularly in patients with limited metastatic burden, potentially identifying patients with indolent disease who are suitable for tailored SBRT interventions.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1468-1478"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}