Key learnings from concordant systematic biopsies in prostate-specific membrane antigen positron emission tomography/computed tomography-guided prostate biopsies: Enhancing targeting accuracy.

Autor: Büttner T; Department of Urology and Paediatric Urology, University Hospital Bonn, Bonn, Germany., Gärtner F; Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany., Essler M; Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany., Weiten R; Department of Urology and Paediatric Urology, University Hospital Bonn, Bonn, Germany., Kristiansen G; Institute of Pathology, University Hospital Bonn, Bonn, Germany., Ellinger J; Department of Urology and Paediatric Urology, University Hospital Bonn, Bonn, Germany., Ritter M; Department of Urology and Paediatric Urology, University Hospital Bonn, Bonn, Germany., Krausewitz P; Department of Urology and Paediatric Urology, University Hospital Bonn, Bonn, Germany.
Jazyk: angličtina
Zdroj: The Prostate [Prostate] 2024 Jun; Vol. 84 (8), pp. 772-779. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1002/pros.24694
Abstrakt: Background: Prostate cancer (PCa) diagnosis and staging have evolved with the advent of 68Ga-Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT). This study investigates the role of complementary systematic biopsies (SB) during PSMA-PET/CT-guided targeted prostate biopsies (PET-TB) for PCa detection, grading, and distribution. We address the uncertainty surrounding the necessity of SB in conjunction with PET-TB.
Methods: We analyzed PCa grading and distribution in 30 men who underwent PET-TB and SB because of contraindication to magnetic resonance imaging or high clinical suspicion of PCa. Tumor distribution was assessed in relation to the PET-highlighted lesions. Standardized reporting schemes, encompassing SUV max , PRIMARY score, and miTNM classification, were evaluated.
Results: 80% of patients were diagnosed with PCa, with 70% classified as clinically significant (csPCa). SB detected more csPCa cases than PET-TB, but the differences were not statistically significant. Discordant results were observed in 25% of cases, where SB outperformed PET-TB. Spatial analysis revealed that tumor-bearing cores from SB were often located in close proximity to the PET-highlighted region. Reporting schemes showed potential for csPCa detection with significantly increased SUV max in csPCA patients. Subsequent follow-up data underscored the importance of SB in precise PCa grading and staging.
Conclusions: While PET-TB can simplify prostate biopsy and reduce invasiveness by core number, SB cannot be omitted yet due to potential PET-TB targeting errors. Factors such as limited spatial resolution and fusion inaccuracies contribute to the need for SB. Standardization in reporting schemes currently cannot compensate for targeting errors highlighting the need for refinement.
(© 2024 The Authors. The Prostate published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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