Pd50-04 Can Psma-Targeted Prostate Biopsy Detect Cancer When Mri-Guided Biopsy Is Negative?

You have accessJournal of UrologyProstate Cancer: Detection all had a previous mpMRI; and within a year of PSMA biopsy, all had a negative MRGB (targeted and/or systematic). After screening with a 68Gallium-PSMA scan, 25/38 had an intra-prostatic PSMA focus (Maximum Standardized Uptake Value, SUVmax >3, range 3-30) and underwent targeted biopsy. PSMA-PET positive Lesions were contoured using Profuse software by co-author J.C.; 12 lesions were posterior; 8 anterior; 5 both. Contoured lesions were networked into an Artemis device, and the 25 study patients underwent targeted biopsy of the PSMA-PET hotspot via PET/CT-US fusion (Figure 1). Targeted cores (∼6) were obtained as with MRGB (Sonn, J.Urol.189: 86, 2013). RESULTS: PSMA-targeted fusion biopsy was completed under local anesthesia in all 25 men without incident in an average time of 15 minutes. 10/25 men (40%) were found to harbor csPCa (GGG>2) in or around the hotspot; 12 (48%) were biopsy-negative; and 3 (12%) had GG1 findings. Of the 10 with csPCa, 4 were GG2 and 6 were >GG3; 4 of the 10 PSMA hotspots overlaid MRI lesions, but 6 were de novo. Maximum cancer core length averaged 4.7 mm +/- 2.6 SD. Both SUVmax and the 'Primary Score' (Emmett, J. Nucl. Med, 2022) were correlated with Gleason Grade Group (Figure 2). When SUVmax was >10, 7 of 10 men had csPCa. When SUVmax was <6, none of 9 men had csPCa. Neither PIRADS grade nor PSA density was related to PSMA-guided biopsy result (p=NS). CONCLUSIONS: Diagnosis of csPCa may be made by targeted biopsy of PSMA hotspots in the prostate, when MRGB is negative. Detection rate of PSMA-targeted biopsy is directly related to SUVmax and Primary Score. Download PPTDownload PPT Source of Funding: NCI-RO1CA218547 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1057 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Wayne G. Brisbane More articles by this author Mark T. Topoozian More articles by this author Jeremie Calais More articles by this author Merdie K. Delfin More articles by this author Lorna Kwan More articles by this author Samantha R. Gonzalez More articles by this author Leonard S. Marks More articles by this author Expand All Advertisement PDF downloadLoading ...