The Sensitivity and Specificity of Multiparametric Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Predicting Seminal Vesicle Invasion in Clinically Significant Prostate Cancer: A Multicenter Retrospective Study.

Autor:	Sitharthan D; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Department of Urology, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia., Kang S; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Treacy PJ; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia., Bird J; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Alexander K; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Karunaratne S; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Leslie S; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Department of Urology, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Chan L; Department of Urology, Concord Repatriation General Hospital (CRGH), Sydney, NSW 2139, Australia., Steffens D; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia., Thanigasalam R; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia.; RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia.; Department of Urology, Concord Repatriation General Hospital (CRGH), Sydney, NSW 2139, Australia.
Jazyk:	angličtina
Zdroj:	Journal of clinical medicine [J Clin Med] 2024 Jul 29; Vol. 13 (15). Date of Electronic Publication: 2024 Jul 29.
DOI:	10.3390/jcm13154424
Abstrakt:	Background/Objectives: The presence of seminal vesicle invasion (SVI) in prostate cancer (PCa) is associated with poorer postoperative outcomes. This study evaluates the predictive value of magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for SVI in PCa. Methods: This cohort study included consecutive robotic prostatectomy patients for PCa at three Australian tertiary referral centres between April 2016 and September 2022. MRI and PSMA PET/CT results, clinicopathological variables, including age, BMI, prostate-specific antigen (PSA), PSA density, DRE, Biopsy Gleason score, Positive biopsy cores, PIRADS v2.1 score, MRI volume and MRI lesion size were extracted. The sensitivity, specificity, and accuracy of MRI and PSMA PET/CT for predicting SVI were compared with the histopathological results by receiver operating characteristic (ROC) analysis. Subgroup univariate and multivariate analysis was performed. Results: Of the 528 patients identified, 86 had SVI on final pathology. MRI had a low sensitivity of 0.162 (95% CI: 0.088-0.261) and a high specificity of 0.963 (95% CI: 0.940-0.979). The PSMA PET/CT had a low sensitivity of 0.439 (95% CI: 0.294-0591) and a high specificity of 0.933 (95% CI: 0.849-0.969). When MRI and PSMA PET/CT were used in combination, the sensitivity and specificity improved to 0.514 (95%CI: 0.356-0.670) and 0.880 (95% CI: 0.813-0.931). The multivariate regression showed a higher biopsy Gleason score ( p = 0.033), higher PSA ( p < 0.001), older age ( p = 0.001), and right base lesions ( p = 0.003) to be predictors of SVI. Conclusions: MRI and PSMA PET/CT independently underpredicted SVI. The sensitivity and AUC improved when they were used in combination. Multiple clinicopathological factors were associated with SVI on multivariate regression and predictive models incorporating this information may improve oncological outcomes.
Databáze:	MEDLINE
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