Using a novel PSMA-PET and PSA-based model to enhance the diagnostic accuracy for clinically significant prostate cancer and avoid unnecessary biopsy in men with PI-RADS ≤ 3 MRI.
MpMRI
PET
PI-RADS
PRIMARY-score
PSMA
Prostate cancer
Journal
European journal of nuclear medicine and molecular imaging
ISSN: 1619-7089
Titre abrégé: Eur J Nucl Med Mol Imaging
Pays: Germany
ID NLM: 101140988
Informations de publication
Date de publication:
15 Oct 2024
15 Oct 2024
Historique:
received:
13
07
2024
accepted:
07
10
2024
medline:
15
10
2024
pubmed:
15
10
2024
entrez:
15
10
2024
Statut:
aheadofprint
Résumé
The diagnostic evaluation of men with suspected prostate cancer (PCa) yet inconclusive MRI (PI-RADS ≤ 3) presents a common clinical challenge. [ This study retrospective included 151 men with clinical suspicion of PCa and PI-RADS ≤ 3 MRI. All men underwent [ In this PI-RADS ≤ 3 cohort, areas-under-the-curve (AUCs) for detecting csPCa were 0.796 (95%CI, 0.738-0.853), 0.851 (95%CI, 0.783-0.918) and 0.806 (95%CI, 0.742-0.870) for PRIMARY-score, SUVmax and routine clinical PSMA-PET assessment, respectively. The diagnostic model comprising PRIMARY-score, SUVmax and serum free PSA/total PSA (fPSA/tPSA) achieved a significantly higher AUC of 0.906 (95%CI, 0.851-0.961) compared to strategies based on PRIMARY-score or SUVmax (P < 0.05) and markedly superior to conventional strategies typically based on PSA density (P < 0.001). The average fivefold cross-validated AUC with 1000 iterations was 0.878 (95%CI, 0.820-0.954). Theoretically, using a threshold of 21.6%, the model could have prevented 78% of unnecessary biopsies while missing only 7.8% of csPCa cases in this cohort. A novel diagnostic model incorporating PSMA-PET derived metrics-PRIMARY-score and SUVmax-along with serum fPSA/tPSA, has been developed and validated. The integrated model may assist clinical decision-making with enhanced diagnostic accuracy over the individual conventional metrics. It has great potential to reduce unnecessary biopsies for men with PI-RADS ≤ 3 MRI results and warrants further prospective and external evaluations.
Identifiants
pubmed: 39404788
doi: 10.1007/s00259-024-06949-7
pii: 10.1007/s00259-024-06949-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Natural Science Foundation of China
ID : 82272045
Organisme : National Natural Science Foundation of China
ID : 82273121
Organisme : National Natural Science Foundation of China
ID : 81801740
Organisme : Science and Technology Innovation Program of Hunan Province
ID : 2021RC4056
Organisme : Natural Science Foundation of Hunan Province
ID : 2022JJ20096
Organisme : Natural Science Foundation of Hunan Province
ID : 2023JJ30939
Organisme : Key Program of Ministray of Industry and Information Technology of China
ID : CEIEC-2022-ZM02-0219
Organisme : China Postdoctoral Science Foundation
ID : 2022M23561
Organisme : Hunan Provincial Science Found for Distinguished Younger Scholars
ID : 2024JJ2094
Organisme : Clinical Research Foundation of the National Clinical Research Center for Geriatric Diseases (XIANGYA)
ID : 2023LNJJ16
Organisme : Innovative Construction Foundation of Hunan Province
ID : 2021SK4001
Organisme : The National Key clinical specialty Major Scientific Research Project of Hunan Province
ID : Z2023004
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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