Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway
Abstract Introduction Prostate-specific antigen (PSA) is a reliable biomarker for identification of prostate cancer, although a biopsy is still the gold standard for detecting prostate cancer. Similar to higher PIRADS lesions on MRI, the maximal standard uptake value (SUV max) on PSMA PET is linked...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-11-01
|
| Series: | European Journal of Hybrid Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41824-023-00182-5 |
| _version_ | 1797630456289558528 |
|---|---|
| author | Aditya Prakash Sharma Rajender Kumar Rohit Chauhan Shiraz Akif Ziauddin Shanky Singh Harmandeep Singh Sudheer Kumar Devana Ujjwal Gorsi Girdhar Singh Bora Ravimohan S. Mavuduru Santosh Kumar Uttam K. Mete Bhagwant Rai Mittal |
| author_facet | Aditya Prakash Sharma Rajender Kumar Rohit Chauhan Shiraz Akif Ziauddin Shanky Singh Harmandeep Singh Sudheer Kumar Devana Ujjwal Gorsi Girdhar Singh Bora Ravimohan S. Mavuduru Santosh Kumar Uttam K. Mete Bhagwant Rai Mittal |
| author_sort | Aditya Prakash Sharma |
| collection | DOAJ |
| description | Abstract Introduction Prostate-specific antigen (PSA) is a reliable biomarker for identification of prostate cancer, although a biopsy is still the gold standard for detecting prostate cancer. Similar to higher PIRADS lesions on MRI, the maximal standard uptake value (SUV max) on PSMA PET is linked to a higher likelihood of prostate cancer. Can an mpMRI in conjunction with PSMA PET Scan accurately predict prostate cancer and further trigger omission of biopsy similar to other solid organ urological malignancies? Methods Ga-68 PSMA PET and mpMRI were performed for each patient who was a part of this retrospective study. The PET-positive lesion's maximum standardized uptake value (SUVmax) was recorded. Prostate biopsies were performed on patients who had PSMA PET avid lesions and a PIRADS score of 4 or 5. Robot-assisted radical prostatectomy (RARP) was afterward performed on patients who had cancer on their prostate biopsy. The prostatectomy specimen's histopathological information was recorded. Cutoff values and correlations between the variables were determined using the ROC curves and Pearson's correlation test. Result On the basis of suspicious DRE findings or elevated PSA, 70 men underwent mpMRI and PET scans. PIRADS 4 patients had a median (IQR) SUVmax of 8.75 (11.95); whereas, PIRADS 5 patients had an SUVmax of 24.5 (22). The mean SUVmax for patients whose biopsies revealed no cancer was 6.25 ± 1.41. With an AUC of 0.876 on the ROC curve, it was found that there was a significant positive correlation between the results of the mpMRI and PET scans and those of the histopathological investigation. A SUVmax ≥ 8.25 on PSMA PET for a PIRADS 4/5 lesion on mpMRI will aid in correctly predicting malignancy, with a sensitivity of 82.8% and specificity of 100%. Conclusion The findings of this study were positive and indicated that patients with a high suspicion of prostate cancer on mpMRI and PSMA PET (PIRADS ≥ 4 and SUVmax ≥ 8.25). This study substantiates the fact that a combination of mpMRI and PSMA PET can accurately predict localized prostate cancer. |
| first_indexed | 2024-03-11T11:08:26Z |
| format | Article |
| id | doaj.art-65ddf68ab8b34c549df54091a72442c7 |
| institution | Directory Open Access Journal |
| issn | 2510-3636 |
| language | English |
| last_indexed | 2024-03-11T11:08:26Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | European Journal of Hybrid Imaging |
| spelling | doaj.art-65ddf68ab8b34c549df54091a72442c72023-11-12T12:04:23ZengSpringerOpenEuropean Journal of Hybrid Imaging2510-36362023-11-017111110.1186/s41824-023-00182-5Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathwayAditya Prakash Sharma0Rajender Kumar1Rohit Chauhan2Shiraz Akif Ziauddin3Shanky Singh4Harmandeep Singh5Sudheer Kumar Devana6Ujjwal Gorsi7Girdhar Singh Bora8Ravimohan S. Mavuduru9Santosh Kumar10Uttam K. Mete11Bhagwant Rai Mittal12Department of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Nuclear Medicine, PGIMERDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Nuclear Medicine, PGIMERDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Radiodiagnosis, PGIMERDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Urology, Advance Urology Centre, PGIMER, Nehru HospitalDepartment of Nuclear Medicine, PGIMERAbstract Introduction Prostate-specific antigen (PSA) is a reliable biomarker for identification of prostate cancer, although a biopsy is still the gold standard for detecting prostate cancer. Similar to higher PIRADS lesions on MRI, the maximal standard uptake value (SUV max) on PSMA PET is linked to a higher likelihood of prostate cancer. Can an mpMRI in conjunction with PSMA PET Scan accurately predict prostate cancer and further trigger omission of biopsy similar to other solid organ urological malignancies? Methods Ga-68 PSMA PET and mpMRI were performed for each patient who was a part of this retrospective study. The PET-positive lesion's maximum standardized uptake value (SUVmax) was recorded. Prostate biopsies were performed on patients who had PSMA PET avid lesions and a PIRADS score of 4 or 5. Robot-assisted radical prostatectomy (RARP) was afterward performed on patients who had cancer on their prostate biopsy. The prostatectomy specimen's histopathological information was recorded. Cutoff values and correlations between the variables were determined using the ROC curves and Pearson's correlation test. Result On the basis of suspicious DRE findings or elevated PSA, 70 men underwent mpMRI and PET scans. PIRADS 4 patients had a median (IQR) SUVmax of 8.75 (11.95); whereas, PIRADS 5 patients had an SUVmax of 24.5 (22). The mean SUVmax for patients whose biopsies revealed no cancer was 6.25 ± 1.41. With an AUC of 0.876 on the ROC curve, it was found that there was a significant positive correlation between the results of the mpMRI and PET scans and those of the histopathological investigation. A SUVmax ≥ 8.25 on PSMA PET for a PIRADS 4/5 lesion on mpMRI will aid in correctly predicting malignancy, with a sensitivity of 82.8% and specificity of 100%. Conclusion The findings of this study were positive and indicated that patients with a high suspicion of prostate cancer on mpMRI and PSMA PET (PIRADS ≥ 4 and SUVmax ≥ 8.25). This study substantiates the fact that a combination of mpMRI and PSMA PET can accurately predict localized prostate cancer.https://doi.org/10.1186/s41824-023-00182-5mpMRIPSMA PETProstate cancerSUVmax |
| spellingShingle | Aditya Prakash Sharma Rajender Kumar Rohit Chauhan Shiraz Akif Ziauddin Shanky Singh Harmandeep Singh Sudheer Kumar Devana Ujjwal Gorsi Girdhar Singh Bora Ravimohan S. Mavuduru Santosh Kumar Uttam K. Mete Bhagwant Rai Mittal Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway European Journal of Hybrid Imaging mpMRI PSMA PET Prostate cancer SUVmax |
| title | Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway |
| title_full | Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway |
| title_fullStr | Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway |
| title_full_unstemmed | Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway |
| title_short | Accuracy of combined multi-parametric MRI and PSMA PET-CT in diagnosing localized prostate cancer: newer horizons for a biopsy-free pathway |
| title_sort | accuracy of combined multi parametric mri and psma pet ct in diagnosing localized prostate cancer newer horizons for a biopsy free pathway |
| topic | mpMRI PSMA PET Prostate cancer SUVmax |
| url | https://doi.org/10.1186/s41824-023-00182-5 |
| work_keys_str_mv | AT adityaprakashsharma accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT rajenderkumar accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT rohitchauhan accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT shirazakifziauddin accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT shankysingh accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT harmandeepsingh accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT sudheerkumardevana accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT ujjwalgorsi accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT girdharsinghbora accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT ravimohansmavuduru accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT santoshkumar accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT uttamkmete accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway AT bhagwantraimittal accuracyofcombinedmultiparametricmriandpsmapetctindiagnosinglocalizedprostatecancernewerhorizonsforabiopsyfreepathway |