Objectives: The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging.
Methods: This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were staged using radiolabeled PSMA PET/CT to evaluate the extent of the disease before initiating appropriate treatment. The study included patients from the Nuclear Medicine Units of the Humanitas group between 2021 and 2024. The change in management due to the PSMA PET/CT examination was assessed.
Results: A total of 181 patients were enrolled across all three centers. Histopathological assessment from biopsy revealed that 51.4% of patients had favorable PCa, while 48.6% had unfavorable disease. PET/CT was positive for the primary lesions in all patients, but it revealed a positivity rate in 23 (12.7%) patients for nodes and distant organs, with a positivity rate of 0.21 in the unfavorable group and 0.05 in the favorable group ( < 0.005). Based on follow-up data, diagnostic accuracy was higher than 90% in both the favorable and unfavorable groups for lymph node and distant metastases. The inclusion of PSMA PET/CT in the diagnostic algorithm for patients with intermediate-risk PCa impacted patient management in 24 (13.3%) cases, based on the multidisciplinary team decision.
Conclusions: PSMA PET/CT can affect the management of patients with intermediate-risk PCa in up to 13% of cases, mainly for unfavorable diseases. New imaging techniques as a first-line imaging procedure can help to plan the correct therapeutic approach in the intermediate-risk PCa group.
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http://dx.doi.org/10.3390/diagnostics14232751 | DOI Listing |
Int Urol Nephrol
January 2025
Faculty of Medical Sciences, Pharmacology and Toxicology Department, University of Kragujevac, Kragujevac, Serbia.
Purposes: Intermediate-risk prostate cancer (IR PCa) is the most common risk group for localized prostate cancer. This study aimed to develop a machine learning (ML) model that utilizes biopsy predictors to estimate the probability of IR PCa and assess its performance compared to the traditional clinical model.
Methods: Between January 2017 and December 2022, patients with prostate-specific antigen (PSA) values of ≤ 20 ng/mL underwent transrectal ultrasonography-guided prostate biopsies.
Cancer
January 2025
Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background: Adverse pathology (AP) is often used as an intermediate end point for long-term outcomes in men with prostate cancer (PCa) who are active surveillance candidates. The association between a commonly used AP definition and long-term outcomes was tested, which identified definitions more strongly linked to a high risk of metastasis.
Methods: Data were reviewed from the Shared Equal Access Regional Cancer Hospital cohort of men undergoing radical prostatectomy (RP) from 1988 to 2020 at nine Veterans Affairs hospitals.
Prostate Int
December 2024
Department of Urology, Keio University, School of Medicine, Tokyo, Japan.
Introduction: Adverse events, such as erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are significant concerns in prostate cancer (PCa) patients treated with Iodine 125 (I-125) low-dose rate (LDR) prostate brachytherapy (PB). Alpha antagonists and phosphodiesterase-5 inhibitors are used to manage these events. The present study compared the efficacy of low-dose tadalafil with that of tamsulosin for concomitant ED and LUTS in PCa patients treated with I-125 LDR PB.
View Article and Find Full Text PDFCurr Issues Mol Biol
December 2024
First Department of Urology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Prostate cancer (PCa) is a common malignancy in men and is among the leading causes of cancer-related death worldwide. Genomic tests assess disease aggressiveness and guide treatment, particularly in low- and intermediate-risk PCa. We reviewed the literature on the use of four genomic tests (Prolaris, Promark, Oncotype DX, and Decipher) in assessing the prognosis of PCa and their use in treatment decision-making.
View Article and Find Full Text PDFRadiology
December 2024
From the Departments of Radiology (F.C., A.L.) and Urology (M.G.), Clinique de l'Alma, 166 Rue de l'Université, 75007 Paris, France; Department of Urology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands (K.d.B., L.v.R.); and Department of Pathology, i-Path Institut de Pathologie des Hauts-de-France, Amiens, France (P.C.).
Background MRI-guided focal laser ablation (FLA) is a promising treatment in localized prostate cancer (PCa). MRI-guided micro-US FLA shows potential for outpatient use, but its clinical application remains unexplored. Purpose To evaluate the safety, feasibility, and 12-month functional and oncologic outcomes of MRI-guided micro-US transperineal FLA in localized PCa and to assess the accuracy of micro-US in showing lesions depicted at MRI with Prostate Imaging Reporting and Data System (PI-RADS) score of 3 or higher.
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