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Open Access 01-07-2021 | Prostate Cancer | Original Article

Detection of prostate cancer with ¹⁸F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial

Authors: Y. J. L. Bodar, B. H. E. Jansen, J. P. van der Voorn, G. J. C. Zwezerijnen, D. Meijer, J. A. Nieuwenhuijzen, R. Boellaard, N. H. Hendrikse, O. S. Hoekstra, R. J. A. van Moorselaar, D. E. Oprea-Lager, A. N. Vis

Published in: World Journal of Urology | Issue 7/2021

Abstract

Purpose

In primary prostate cancer (PCa) patients, accurate staging and histologic grading are crucial to guide treatment decisions. ¹⁸F-DCFPyL (PSMA)-PET/CT has been successfully introduced for (re)staging PCa, showing high accuracy to localise PCa in lymph nodes and/or osseous structures. The diagnostic performance of ¹⁸F-DCFPyL-PET/CT in localizing primary PCa within the prostate gland was assessed, allowing for PSMA-guided targeted-prostate biopsy.

Methods

Thirty patients with intermediate-/high-risk primary PCa were prospectively enrolled between May 2018 and May 2019 and underwent ¹⁸F-DCFPyL-PET/CT prior to robot-assisted radical prostatectomy (RARP). Two experienced and blinded nuclear medicine physicians assessed tumour localisation within the prostate gland on PET/CT, using a 12-segment mapping model of the prostate. The same model was used by a uro-pathologist for the RARP specimens. Based on PET/CT imaging, a potential biopsy recommendation was given per patient, based on the size and PET-intensity of the suspected PCa localisations. The biopsy recommendation was correlated to final histopathology in the RARP specimen. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for clinically significant PCa (csPCa, Gleason score ≥ 3 + 4 = 7) were assessed.

Results

The segments recommended for potential targeted biopsy harboured csPCA in 28/30 patients (93%), and covered the highest Gleason score PCa segment in 26/30 patient (87%). Overall, 122 of 420 segments (29.0%) contained csPCa at final histopathological examination. Sensitivity, specificity, PPV and NPV for csPCa per segment using ¹⁸F-DCFPyL-PET/CT were 61.4%, 88.3%, 68.1% and 84.8%, respectively.

Conclusions

When comparing the PCa-localisation on ¹⁸F-DCFPyL-PET/CT with the RARP specimens, an accurate per-patient detection (93%) and localisation of csPCa was found. Thus, ¹⁸F-DCFPyL-PET/CT potentially allows for accurate PSMA-targeted biopsy.

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Title: Detection of prostate cancer with 18F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial
Authors: Y. J. L. Bodar
B. H. E. Jansen
J. P. van der Voorn
G. J. C. Zwezerijnen
D. Meijer
J. A. Nieuwenhuijzen
R. Boellaard
N. H. Hendrikse
O. S. Hoekstra
R. J. A. van Moorselaar
D. E. Oprea-Lager
A. N. Vis
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Published in: World Journal of Urology / Issue 7/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03490-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Detection of prostate cancer with ¹⁸F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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