Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer
Purpose of the Report: Although multiparametric magnetic resonance imaging (mpMRI) is commonly used for the primary staging of prostate cancer, it may miss non-enlarged metastatic lymph nodes. Positron emission tomography-computed tomography targeting the prostate-specific membrane antigen (PSMA PET...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/24/5838 |
| _version_ | 1797381698539749376 |
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| author | Omar Marek Tayara Kacper Pełka Jolanta Kunikowska Wojciech Malewski Katarzyna Sklinda Hubert Kamecki Sławomir Poletajew Piotr Kryst Łukasz Nyk |
| author_facet | Omar Marek Tayara Kacper Pełka Jolanta Kunikowska Wojciech Malewski Katarzyna Sklinda Hubert Kamecki Sławomir Poletajew Piotr Kryst Łukasz Nyk |
| author_sort | Omar Marek Tayara |
| collection | DOAJ |
| description | Purpose of the Report: Although multiparametric magnetic resonance imaging (mpMRI) is commonly used for the primary staging of prostate cancer, it may miss non-enlarged metastatic lymph nodes. Positron emission tomography-computed tomography targeting the prostate-specific membrane antigen (PSMA PET-CT) is a promising method to detect non-enlarged metastatic lymph nodes, but more data are needed. Materials and Methods: In this single-center, prospective study, we enrolled patients with intermediate-to-high-risk prostate cancer scheduled for radical prostatectomy with pelvic node dissection. Before surgery, prostate imaging with mpMRI and PSMA PET-CT was used to assess lymph node involvement (LNI), extra-prostatic extension (EPE), and seminal vesicle involvement (SVI). Additionally, we used clinical nomograms to estimate the risk of these three outcomes. Results: Of the 74 patients included, 61 (82%) had high-risk prostate cancer, and the rest had intermediate-risk cancer. Histopathology revealed LNI in 20 (27%) patients, SVI in 26 (35%), and EPE in 52 (70%). PSMA PET-CT performed better than mpMRI at detecting LNI (area under the curve (AUC, 95% confidence interval): 0.779 (0.665–0.893) vs. 0.655 (0.529–0.780)), but mpMRI was better at detecting SVI (AUC: 0.775 (0.672–0.878) vs. 0.585 (0.473–0.698)). The MSKCC nomogram performed well at detecting both LNI (AUC: 0.799 (0.680–0.918)) and SVI (0.772 (0.659–0.885)). However, when the nomogram was used to derive binary diagnoses, decision curve analyses showed that the MSKCC nomogram provided less net benefit than mpMRI and PSMA PET-CT for detecting SVI and LNI, respectively. Conclusions: mpMRI and [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT are complementary techniques to be used in conjunction for the primary T and N staging of prostate cancer. |
| first_indexed | 2024-03-08T20:56:12Z |
| format | Article |
| id | doaj.art-e839d48ff7e5422292204c8dff74d1a3 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T20:56:12Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e839d48ff7e5422292204c8dff74d1a32023-12-22T13:59:01ZengMDPI AGCancers2072-66942023-12-011524583810.3390/cancers15245838Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate CancerOmar Marek Tayara0Kacper Pełka1Jolanta Kunikowska2Wojciech Malewski3Katarzyna Sklinda4Hubert Kamecki5Sławomir Poletajew6Piotr Kryst7Łukasz Nyk8Second Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandDepartment of Nuclear Medicine, Medical University of Warsaw, 02-097 Warsaw, PolandDepartment of Nuclear Medicine, Medical University of Warsaw, 02-097 Warsaw, PolandSecond Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandDepartment of Radiology, Centre of Postgraduate Medical Education, 01-809 Warsaw, PolandSecond Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandSecond Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandSecond Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandSecond Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, PolandPurpose of the Report: Although multiparametric magnetic resonance imaging (mpMRI) is commonly used for the primary staging of prostate cancer, it may miss non-enlarged metastatic lymph nodes. Positron emission tomography-computed tomography targeting the prostate-specific membrane antigen (PSMA PET-CT) is a promising method to detect non-enlarged metastatic lymph nodes, but more data are needed. Materials and Methods: In this single-center, prospective study, we enrolled patients with intermediate-to-high-risk prostate cancer scheduled for radical prostatectomy with pelvic node dissection. Before surgery, prostate imaging with mpMRI and PSMA PET-CT was used to assess lymph node involvement (LNI), extra-prostatic extension (EPE), and seminal vesicle involvement (SVI). Additionally, we used clinical nomograms to estimate the risk of these three outcomes. Results: Of the 74 patients included, 61 (82%) had high-risk prostate cancer, and the rest had intermediate-risk cancer. Histopathology revealed LNI in 20 (27%) patients, SVI in 26 (35%), and EPE in 52 (70%). PSMA PET-CT performed better than mpMRI at detecting LNI (area under the curve (AUC, 95% confidence interval): 0.779 (0.665–0.893) vs. 0.655 (0.529–0.780)), but mpMRI was better at detecting SVI (AUC: 0.775 (0.672–0.878) vs. 0.585 (0.473–0.698)). The MSKCC nomogram performed well at detecting both LNI (AUC: 0.799 (0.680–0.918)) and SVI (0.772 (0.659–0.885)). However, when the nomogram was used to derive binary diagnoses, decision curve analyses showed that the MSKCC nomogram provided less net benefit than mpMRI and PSMA PET-CT for detecting SVI and LNI, respectively. Conclusions: mpMRI and [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT are complementary techniques to be used in conjunction for the primary T and N staging of prostate cancer.https://www.mdpi.com/2072-6694/15/24/5838PSMA[<sup>68</sup>Ga]Ga-PSMA-11prostate cancernomogramsPET-CT |
| spellingShingle | Omar Marek Tayara Kacper Pełka Jolanta Kunikowska Wojciech Malewski Katarzyna Sklinda Hubert Kamecki Sławomir Poletajew Piotr Kryst Łukasz Nyk Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer Cancers PSMA [<sup>68</sup>Ga]Ga-PSMA-11 prostate cancer nomograms PET-CT |
| title | Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer |
| title_full | Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer |
| title_fullStr | Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer |
| title_full_unstemmed | Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer |
| title_short | Comparison of Multiparametric MRI, [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT, and Clinical Nomograms for Primary T and N Staging of Intermediate-to-High-Risk Prostate Cancer |
| title_sort | comparison of multiparametric mri sup 68 sup ga ga psma 11 pet ct and clinical nomograms for primary t and n staging of intermediate to high risk prostate cancer |
| topic | PSMA [<sup>68</sup>Ga]Ga-PSMA-11 prostate cancer nomograms PET-CT |
| url | https://www.mdpi.com/2072-6694/15/24/5838 |
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