The Challenge of External Generalisability: Insights from the Bicentric Validation of a [Ga]Ga-PSMA-11 PET Based Radiomics Signature for Primary Prostate Cancer Characterisation Using Histopathology as Reference.

: PSMA PET radiomics is a promising tool for primary prostate cancer (PCa) characterisation. However, small single-centre studies and lack of external validation hinder definitive conclusions on the potential of PSMA PET radiomics in the initial workup of PCa. We aimed to validate a radiomics signature in a larger internal cohort and in an external cohort from a separate centre.

Defining the optimal target-to-background ratio to identify positive lymph nodes in prostate cancer patients undergoing robot-assisted [Tc]Tc-PSMA radioguided surgery: updated results and ad interim analyses of a prospective phase II study.

Introduction: Prostate-specific membrane antigen radioguided surgery (PSMA-RGS) might identify lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing extended pelvic lymph node dissection (ePLND). The optimal target-to-background (TtB) ratio to define RGS positivity is still unknown.

Materials & Methods: Ad interim analyses which focused on 30 patients with available pathological information were conducted.

Diagnostic accuracy of fully hybrid [Ga]Ga-PSMA-11 PET/MRI and [Ga]Ga-RM2 PET/MRI in patients with biochemically recurrent prostate cancer: a prospective single-center phase II clinical trial.

Purpose: To compare the diagnostic accuracy and detection rates of PET/MRI with [Ga]Ga-PSMA-11 and [Ga]Ga-M2 in patients with biochemical recurrence of prostate cancer (PCa).

Methods: Sixty patients were enrolled in this prospective single-center phase II clinical trial from June 2020 to October 2022. Forty-four/60 completed all study examinations and were available at follow-up (median: 22.

Predictors of PSMA PET Positivity: Analysis in a Selected Cohort of Biochemical Recurrence Prostate Cancer Patients after Radical Prostatectomy.

Localized prostate cancer (PCa) can be treated with radical prostatectomy (RP). Up to 30% of patients undergoing this procedure experience biochemical recurrence (BCR), namely the rise in serum prostate-specific antigen (PSA) levels during the post-surgical follow-up, requiring further treatments and with the risk of severe disease progression. Currently, the most accurate imaging technique to confirm, detect, and locate disease relapses in BCR patients is prostate-specific membrane antigen (PSMA)-targeted PET, as recommended by international clinical guidelines.

Systematic Review and Metanalysis on the Role of Prostate-Specific Membrane Antigen Positron Emission Tomography/Magnetic Resonance Imaging for Intraprostatic Tumour Assessment.

The present systematic review and meta-analysis are focused on the diagnostic accuracy of PSMA PET/MRI in primary prostate cancer assessment. A literature search was conducted on the PubMed database using the terms "PSMA" AND "prostate cancer" or "prostate" AND "PET/MRI" or "PET MRI" or "PET-MRI" or "PET-MR" AND "primary" or "staging." Ten articles were eligible for analysis after applying the exclusion criteria.

[Ga]Ga-PSMA and [Ga]Ga-RM2 PET/MRI vs. Histopathological Images in Prostate Cancer: A New Workflow for Spatial Co-Registration.

This study proposed a new workflow for co-registering prostate PET images from a dual-tracer PET/MRI study with histopathological images of resected prostate specimens. The method aims to establish an accurate correspondence between PET/MRI findings and histology, facilitating a deeper understanding of PET tracer distribution and enabling advanced analyses like radiomics. To achieve this, images derived by three patients who underwent both [Ga]Ga-PSMA and [Ga]Ga-RM2 PET/MRI before radical prostatectomy were selected.

Role of [Ga]Ga-PSMA-11 PET radiomics to predict post-surgical ISUP grade in primary prostate cancer.

Purpose: The aim of this study is to investigate the role of [Ga]Ga-PSMA-11 PET radiomics for the prediction of post-surgical International Society of Urological Pathology (ISUP) grade in primary prostate cancer (PCa).

Methods: This retrospective study included 47 PCa patients who underwent [Ga]Ga-PSMA-11 PET at IRCCS San Raffaele Scientific Institute before radical prostatectomy. The whole prostate was manually contoured on PET images and 103 image biomarker standardization initiative (IBSI)-compliant radiomic features (RFs) were extracted.

External validation of a convolutional neural network for the automatic segmentation of intraprostatic tumor lesions on Ga-PSMA PET images.

Introduction: State of the art artificial intelligence (AI) models have the potential to become a "one-stop shop" to improve diagnosis and prognosis in several oncological settings. The external validation of AI models on independent cohorts is essential to evaluate their generalization ability, hence their potential utility in clinical practice. In this study we tested on a large, separate cohort a recently proposed state-of-the-art convolutional neural network for the automatic segmentation of intraprostatic cancer lesions on PSMA PET images.

Prostate-specific membrane antigen Radioguided Surgery to Detect Nodal Metastases in Primary Prostate Cancer Patients Undergoing Robot-assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: Results of a Planned Interim Analysis of a Prospective Phase 2 Study.

Background: Extended pelvic nodal dissection (ePLND) represents the gold standard for nodal staging in prostate cancer (PCa). Prostate-specific membrane antigen (PSMA) radioguided surgery (RGS) could identify lymph node invasion (LNI) during robot-assisted radical prostatectomy (RARP).

Objective: To report the planned interim analyses of a phase 2 prospective study (NCT04832958) aimed at describing PSMA-RGS during RARP.

Ga-PSMA and Ga-DOTA-RM2 PET/MRI in Recurrent Prostate Cancer: Diagnostic Performance and Association with Clinical and Histopathological Data.

The aim of the present study is to investigate and compare the performances of Ga-PSMA and Ga-DOTA-RM2 PET/MRI in identifying recurrent prostate cancer (PCa) after primary treatment and to explore the association of dual-tracer PET findings with clinical and histopathological characteristics. Thirty-five patients with biochemical relapse (BCR) of PCa underwent Ga PSMA PET/MRI for restaging purpose, with 31/35 also undergoing Ga-DOTA-RM2 PET/MRI scan within 16 days (mean: 3 days, range: 2-16 days). Qualitative and quantitative image analysis has been performed by comparing Ga-PSMA and Ga-DOTA-RM2 PET/MRI findings both on a patient and lesion basis.

Preliminary Results of an Ongoing Prospective Clinical Trial on the Use of Ga-PSMA and Ga-DOTA-RM2 PET/MRI in Staging of High-Risk Prostate Cancer Patients.

The aim of the present study is to investigate the synergic role of Ga-PSMA PET/MRI and Ga-DOTA-RM2 PET/MRI in prostate cancer (PCa) staging. We present pilot data on twenty-two patients with biopsy-proven PCa that underwent Ga-PSMA PET/MRI for staging purposes, with 19/22 also undergoing Gaa-DOTA-RM2 PET/MRI. TNM classification based on image findings was performed and quantitative imaging parameters were collected for each scan.

State of the art of radiomic analysis in the clinical management of prostate cancer: A systematic review.

We present the current clinical applications of radiomics in the context of prostate cancer (PCa) management. Several online databases for original articles using a combination of the following keywords: "(radiomic or radiomics) AND (prostate cancer or prostate tumour or prostate tumor or prostate neoplasia)" have been searched. The selected papers have been pooled as focus on (i) PCa detection, (ii) assessing the clinical significance of PCa, (iii) biochemical recurrence prediction, (iv) radiation-therapy outcome prediction and treatment efficacy monitoring, (v) metastases detection, (vi) metastases prediction, (vii) prediction of extra-prostatic extension.

Moderately Hypofractionated Helical IMRT, FDG-PET/CT-guided, for Progressive Malignant Pleural Mesothelioma in Patients With Intact Lungs.

Introduction: The objective of this study was to present the outcomes of moderately hypofractionated helical intensity-modulated radiation therapy (HT) with/without simultaneous integrated boost (SIB) on fluorodeoxyglucose-positron emission tomography (FDG-PET) positive areas (gross tumor volume [GTV]-PET) for patients with progressive malignant pleural mesothelioma (MPM) after previous treatments.

Methods And Materials: From May 2006 to April 2014, 51 patients with a median age of 68.8 years (range, 38.

[Cardiac stem cell therapy for the treatment of chronic stable angina refractory to conventional therapy. State of the art and current clinical experience of the San Raffaele Hospital of Milan, Italy].

Background: Cardiac stem cell therapy is a field of scientific research with the goal to translate into clinical benefit the initial findings obtained in basic research laboratories. We have moved into clinical trials in different disease categories: acute myocardial infarction, chronic stable angina refractory to conventional therapy and heart failure. So far we have faced with contradictory results.

[11C]choline-PET-guided helical tomotherapy and estramustine in a patient with pelvic-recurrent prostate cancer: local control and toxicity profile after 24 months.

[11C]choline positron emission tomograhy can be useful to detect metastatic disease and to localize isolated lymph node relapse after primary treatment in case of prostate-specific antigen failure. In case of lymph node failure in prostate cancer patients, surgery or radiotherapy can be proposed with a curative intent. Some reports have suggested that radiotherapy could have a role in local control of oligometastatic lymph node disease.

Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: case report and literature review.

Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice.

High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging.

Objective: The purpose of this study was to assess the value of 2-[F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([F]FDG PET/CT) in the primary staging of high-risk endometrial cancer patients.

Methods: This retrospective study was conducted on 32 consecutive patients with histological diagnosis of primary high-risk endometrial cancer, who underwent PET/CT with [F]FDG in addition to conventional clinical and instrumental staging procedures. After surgery, [F]FDG PET/CT findings were correlated with pathological findings on a patient-by-patient basis.

Radio-guided surgery for lymph node recurrences of differentiated thyroid cancer.

The objectives of this study were to assess the reliability of radio-iodine (131I) and a gamma probe for radio-guided surgery (RGS) to detect and then radically dissect lymph node recurrences (LNRs) in 10 patients with differentiated thyroid cancer (DTC). The major inclusion criterion was the presence of an iodine-positive LNR after previous total thyroidectomy and at least two ineffective 131I treatments. The protocol was designed as follows.

The role of nuclear medicine in infantile hydronephrosis.

Unilateral hydronephrosis due to obstruction of the uretero-pelvic junction is one of the most common indications for scintigraphic evaluation of the kidneys in the pediatric patient. In these cases, dynamic renal scintigraphy-both standard and after diuretic administration--is a simple and well-established procedure, allowing demonstration of structural and functional abnormalities of the involved kidney, with relatively low radiation dose to the child. Scintigraphic procedures allow the differential diagnosis between obstructive and non obstructive causes as well as an estimation of renal function of the hydronephrotic kidney providing indication for a conservative or a surgical approach.