Comparative Performance of (68)Ga-PSMA-11 PET/CT and Conventional Imaging in the Primary Staging of High-Risk Prostate Cancer Patients Who Are Candidates for Radical Prostatectomy. in Diagnostics (Basel, Switzerland) / Diagnostics (Basel). 2024 Sep 5;14(17):1964. doi: 10.3390/diagnostics14171964.

2024
AOU Città della Salute di Torino

Tipo pubblicazione

Journal Article

Autori/Collaboratori (16)Vedi tutti...

Rovera G
Nuclear Medicine Division, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Grimaldi S
Nuclear Medicine Division, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy.
Oderda M
Urology Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, 10126 Turin, Italy.

et alii...

Abstract

This prospective study aimed to (1) compare the diagnostic performance of (68)Ga-PSMA-11 PET/CT with respect to conventional imaging (computed tomography (CT) and bone scintigraphy (BS)) in the primary staging of high-risk prostate cancer (PCa) patients and (2) validate PSMA-PET/CT accuracy in pelvic nodal staging in comparison with postoperative histopathology and assess PSMA-PET/CT's impact on patient management. Sixty castration-sensitive high-risk (ISUP 4-5 and/or PSA > 20 ng/mL and/or cT3) PCa patients eligible for radical prostatectomy were enrolled (median PSA 10.10 [IQR: 6.22-17.95] ng/mL). PSMA-PET/CT, compared with CT, identified nodal (N) and/or distant metastases (M1) in 56.7% (34/60) vs. 13.3% (8/60) (p < 0.001) of patients: N + 45% vs. 13.3% (p < 0.001), M1a 11.7% vs. 1.7% (p = 0.03), M1b 23.3% vs. 1.7% (p < 0.001). Compared with BS, PSMA-PET/CT localized unknown skeletal metastases in 15% (9/60) of cases, with no false negative findings. Overall, PSMA-PET/CT led to a TNM upstaging in 45.0% (27/60) of cases, with no evidence of downstaging, resulting in a change in management in up to 28.8% (17/59) of patients. Compared with histopathology data (n = 32 patients), the per-patient accuracy of PSMA-PET/TC for detecting pelvic nodal metastases was 90.6%. Overall, the above evidence supports the use of PSMA-PET/CT in the diagnostic workup of high-risk prostate cancer staging.

Accesso banca dati bibliografica

PMID : 39272748

DOI : 10.3390/diagnostics14171964

Keywords

hormone-sensitive prostate cancer; PSMA PET; conventional imaging; positron emission tomography; primary staging; prostate cancer;