Mp49-01 Additive Utility of 68 Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Prostate Cancer Diagnosis: Is There a Case for “Seeing Is Believing”?

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP49)1 May 2024MP49-01 ADDITIVE UTILITY OF 68GA-PROSTATE-SPECIFIC MEMBRANE ANTIGEN POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN PROSTATE CANCER DIAGNOSIS: IS THERE A CASE FOR "SEEING IS BELIEVING"? Joel Chin, Yu Guang Tan, Alvin Lee, Tze Kiat Ng, Yan Mee Law, Charlene Tang, Winnie Lam, Ruoyu Shi, Jeffrey Tuan, Henry Ho, John Yuen, and Kenneth Chen Joel ChinJoel Chin , Yu Guang TanYu Guang Tan , Alvin LeeAlvin Lee , Tze Kiat NgTze Kiat Ng , Yan Mee LawYan Mee Law , Charlene TangCharlene Tang , Winnie LamWinnie Lam , Ruoyu ShiRuoyu Shi , Jeffrey TuanJeffrey Tuan , Henry HoHenry Ho , John YuenJohn Yuen , and Kenneth ChenKenneth Chen View All Author Informationhttps://doi.org/10.1097/01.JU.0001008696.31772.28.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (mpMRI) has resulted in a reduction in the number of patients indicated for prostate biopsy. 68Ga-Prostate-specific membrane antigen (PSMA-11) positron emission tomography/computed tomography (PET/CT) has recently shown additional value in detecting clinically significant prostate cancer (csPCa). Combining these imaging modalities may offer the potential to predict for presence of csPCa without the need for invasive biopsy. METHODS: Retrospective analysis of 53 consecutive patients who underwent mpMRI, 68Ga-PSMA-11 PET/CT, and radical prostatectomy (RP) was carried out. The accuracy of 68Ga-PSMA-11 PET/CT, mpMRI alone, and the two procedures in combination were analysed for identifying ISUP grades≥2 within a lesion-based model (n=123) using biopsy and prostatectomy histopathology as reference standard. RESULTS: On a per-patient basis, the sensitivities for 68Ga-PSMA-11 PET/CT and mpMRI in identifying ISUP grades≥2 were both 100%. Assessing ISUP grade≥2 PCa using a lesion-based analysis, 68Ga-PSMA-11 PET/CT demonstrated greater specificity and positive predictive value (PPV) with values of 72.4% (vs 41.4%) and 89% (vs 82%), while mpMRI (Prostate Imaging Reporting and Data System PIRADS 4 – 5) had better sensitivity and negative predictive value (NPV) with values of 90.7% (vs 77%) and 60% (vs 51%). When used in combination (mpMRI PIRADS 4-5 and 68Ga-PSMA-11 PET/CT), sensitivity, specificity, PPV, and NPV were 73.6%, 82.8%, 93%, 51% respectively.Subgroup analysis of PIRADS 3, 4, and 5 lesions were carried out. For PIRADS 3 lesions, 68Ga-PSMA-11 PET/CT demonstrated a NPV of 78%. For PIRADS 4 and 5 lesions, 68Ga-PSMA-11 PET/CT achieved a PPV of 82% and 100% respectively, with a NPV of 100% as well in PIRADS 5 lesions. CONCLUSIONS: Combination of 68Ga-PSMA-11 PET/CT and mpMRI improves the radiological diagnosis of csPCa. In addition, 68Ga-PSMA-11 PET/CT demonstrates potential to guide biopsy for patients with PIRADS 3 lesions on mpMRI. Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e782 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Joel Chin More articles by this author Yu Guang Tan More articles by this author Alvin Lee More articles by this author Tze Kiat Ng More articles by this author Yan Mee Law More articles by this author Charlene Tang More articles by this author Winnie Lam More articles by this author Ruoyu Shi More articles by this author Jeffrey Tuan More articles by this author Henry Ho More articles by this author John Yuen More articles by this author Kenneth Chen More articles by this author Expand All Advertisement PDF downloadLoading ...