Beyond Prostate Imaging Reporting and Data System: Combining Magnetic Resonance Imaging Prostate Imaging Reporting and Data System and Prostate-Specific Membrane Antigen-Positron Emission Tomography/Computed Tomography PRIMARY Score in a Composite (P) Score for More Accurate Diagnosis of Clinically Significant Prostate Cancer.

Autor:	Emmett L; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia.; Garvan Institute of Medical Research, Sydney, Australia.; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., Papa N; Garvan Institute of Medical Research, Sydney, Australia., Hope TA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California., Fendler W; Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany., Calais J; Ahmanson Translational Theranostics, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California., Burger I; Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland., Eiber M; Department of Nuclear Medicine, School of Medicine, Technical University Munich, Munich, Germany., Barbato F; Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany., Moon D; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Counter W; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia., John N; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia.; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., Xue A; Department of Surgery, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia., Franklin A; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia., Thompson J; Garvan Institute of Medical Research, Sydney, Australia.; Department of Urology, St Vincent's Hospital Sydney, Sydney, Australia., Rasiah K; Royal North Shore Hospital, Sydney, Australia., Frydenberg M; Department of Surgery, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia., Yaxley J; The Wesley Hospital, Brisbane, Australia., Buteau J; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Department of Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer, Melbourne, Australia., Agrawal S; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia.; Garvan Institute of Medical Research, Sydney, Australia., Ho B; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia., Nguyen A; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia., Liu V; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia., Lee J; Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia., Woo H; Department of Uro-Oncology, Chris O'Brien Lifehouse, Sydney, Australia., Hsiao E; Department of Uro-Oncology, Chris O'Brien Lifehouse, Sydney, Australia., Sutherland T; Department of Radiology, St Vincent's Hospital, Melbourne, Australia., Perry E; Department of Radiology, St Vincent's Hospital, Melbourne, Australia., Stricker P; Department of Urology, St Vincent's Hospital Sydney, Sydney, Australia., Hofman MS; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Department of Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer, Melbourne, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia., Kasivisvanathan V; Division of Surgery and Interventional Science, University College London, London, United Kingdom., Roberts M; Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany., Murphy D; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2024 Aug; Vol. 212 (2), pp. 299-309. Date of Electronic Publication: 2024 May 17.
DOI:	10.1097/JU.0000000000004010
Abstrakt:	Purpose: The Prostate Imaging Reporting and Data System (PI-RADS) score is standard of care for clinically significant prostate cancer (csPCa) diagnosis. The PRIMARY score (prostate-specific membrane antigen [PSMA]-positron emission tomography [PET]/CT) also has high diagnostic accuracy for csPCa. This study aimed to develop an easily calculated combined (P) score for csPCa detection (International Society of Urological Pathology [ISUP] ≥2) incorporating separately read PI-RADS and PRIMARY scores, with external validation. Materials and Methods: Two datasets of men with suspected PCa, no prior biopsy, recent MRI and 68 Ga-PSMA-11-PET/CT, and subsequent transperineal biopsy were evaluated. These included the development sample (n = 291, 56% csPCa) a prospective trial and the validation sample (n = 227, 67% csPCa) a multicenter retrospective database. Primary outcome was detection of csPCa (ISUP ≥2), with ISUP ≥ 3 cancer detection a secondary outcome. Score performance was evaluated by area under the curve, sensitivity, specificity, and decision curve analysis. Results: The 5-point combined (P) score was developed in a prospective dataset. In the validation dataset, csPCa was identified in 0%, 20%, 52%, 96%, and 100% for P score 1 to 5. The area under the curve was 0.93 (95% CI: 0.90-0.96), higher than PI-RADS 0.89 (95% CI: 0.85-0.93, P = .039) and PRIMARY score alone 0.84 (95% CI: 0.79-0.89, P < .001). Splitting scores at 1/2 (negative) vs 3/4/5 (positive), P score sensitivity was 94% (95% CI: 89-97) compared to PI-RADS 89% (95% CI: 83-93) and PRIMARY score 86% (95% CI: 79-91). For ISUP ≥ 3, P score sensitivity was 99% (95% CI: 95-100) vs 94% (95% CI: 88-98) and 92% (95% CI: 85-97) for PI-RADS and PRIMARY scores respectively. A maximum standardized uptake value > 12 (P score 5) was ISUP ≥ 2 in all cases with 93% ISUP ≥ 3. Conclusions: The P score is easily calculated and improves accuracy for csPCa over both PI-RADS and PRIMARY scores. It should be considered when PSMA-PET is undertaken for diagnosis.
Databáze:	MEDLINE
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