Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer

IntroductionThis study aimed to assess the diagnostic efficacy of the PRIMARY score, based on the 18F-labeled prostate-specific membrane antigen (PSMA-1007) positron emission tomography (PET)/computed tomography (CT) with multiparametric magnetic resonance imaging (mpMRI) PI-RADS, in detecting clini...

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Main Authors: Zhilong Ma, HaiTong Hao, Jian Chen, Tong Pan, Qian Zhao, YanMei Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1589212/full
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author Zhilong Ma
HaiTong Hao
HaiTong Hao
Jian Chen
Jian Chen
Tong Pan
Tong Pan
Qian Zhao
YanMei Li
author_facet Zhilong Ma
HaiTong Hao
HaiTong Hao
Jian Chen
Jian Chen
Tong Pan
Tong Pan
Qian Zhao
YanMei Li
author_sort Zhilong Ma
collection DOAJ
description IntroductionThis study aimed to assess the diagnostic efficacy of the PRIMARY score, based on the 18F-labeled prostate-specific membrane antigen (PSMA-1007) positron emission tomography (PET)/computed tomography (CT) with multiparametric magnetic resonance imaging (mpMRI) PI-RADS, in detecting clinically significant prostate cancer (csPCa).Materials and MethodsIn this retrospective cohort study, 137 patients with suspected prostate cancer (PCa) underwent [18F]PSMA-1007 PET/CT and mpMRI before transrectal ultrasound (TRUS)-guided needle biopsy was performed. Patients were categorized into csPCa and non-csPCa groups based on histopathological findings. The diagnostic performance of total prostate-specific antigen (TPSA), maximum standardized uptake value (SUVmax), the standardized Prostate Imaging Reporting and Data System (PI-RADS v2. 1) of mpMRI, and the PRIMARY score was evaluated using receiver operating characteristic (ROC) curves. The area under the curve (AUC), sensitivity, and specificity were calculated. Factors with a P-value <0.05 from the univariate analysis were included in a binary logistic regression model to develop a predictive model. Differences in the AUCs for TPSA, SUVmax, PI-RADS v2.1, the PRIMARY score, and the combined model were compared using MedCalc software. Statistical significance was set at P<0.05.ResultsAmong the 137 patients evaluated, 67.2% (92) were in csPCa and 32.8% (45) in the non-csPCa group (15 with low-grade PCa [GS 3 + 3] and 30 with benign prostatic hyperplasia or acute or chronic prostatitis). TPSA, SUVmax, PI-RADSv2.1, and the PRIMARY score significantly differed between the two groups (P<0.013). The AUCs for TPSA, SUVmax, PI-RADSv2.1, and PRIMARY score were 0.699, 0.898, 0.878, and 0.910, respectively, with corresponding diagnostic sensitivities of 53.3%, 87.0%, 90.2%, and 83.7%, and specificities of23.0%, 65. 1%, 42.6%, and 58.5%, respectively. The predictive ROC curve analysis of the model revealed an AUC of 0.968, with 91.3% sensitivity, and 84.6% specificity. MedCalc analysis showed that the AUC of the model was superior compared with that of SUVmax, PI-RADS v2.1 Score, and the PRIMARY score. The difference was statistically significant (Z= 2.273, 3.485, 2.761; P=0.023, 0.000, 0.005).ConclusionsThe 5-grade PRIMARY score, derived from [18F]PSMA-1007 PET/CT in conjunction with the PI-RADSv2.1 score, offers enhanced discrimination of csPCa.
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spelling doaj-art-63e2f4c05a2b435f8ff6304a0aa977062025-08-20T03:21:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15892121589212Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancerZhilong Ma0HaiTong Hao1HaiTong Hao2Jian Chen3Jian Chen4Tong Pan5Tong Pan6Qian Zhao7YanMei Li8Nuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaNuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaCollege of Clinical Medicine, Ningxia Medical University, Yinchuan, ChinaNuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaCollege of Clinical Medicine, Ningxia Medical University, Yinchuan, ChinaNuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaCollege of Clinical Medicine, Ningxia Medical University, Yinchuan, ChinaNuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaNuclear Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, ChinaIntroductionThis study aimed to assess the diagnostic efficacy of the PRIMARY score, based on the 18F-labeled prostate-specific membrane antigen (PSMA-1007) positron emission tomography (PET)/computed tomography (CT) with multiparametric magnetic resonance imaging (mpMRI) PI-RADS, in detecting clinically significant prostate cancer (csPCa).Materials and MethodsIn this retrospective cohort study, 137 patients with suspected prostate cancer (PCa) underwent [18F]PSMA-1007 PET/CT and mpMRI before transrectal ultrasound (TRUS)-guided needle biopsy was performed. Patients were categorized into csPCa and non-csPCa groups based on histopathological findings. The diagnostic performance of total prostate-specific antigen (TPSA), maximum standardized uptake value (SUVmax), the standardized Prostate Imaging Reporting and Data System (PI-RADS v2. 1) of mpMRI, and the PRIMARY score was evaluated using receiver operating characteristic (ROC) curves. The area under the curve (AUC), sensitivity, and specificity were calculated. Factors with a P-value <0.05 from the univariate analysis were included in a binary logistic regression model to develop a predictive model. Differences in the AUCs for TPSA, SUVmax, PI-RADS v2.1, the PRIMARY score, and the combined model were compared using MedCalc software. Statistical significance was set at P<0.05.ResultsAmong the 137 patients evaluated, 67.2% (92) were in csPCa and 32.8% (45) in the non-csPCa group (15 with low-grade PCa [GS 3 + 3] and 30 with benign prostatic hyperplasia or acute or chronic prostatitis). TPSA, SUVmax, PI-RADSv2.1, and the PRIMARY score significantly differed between the two groups (P<0.013). The AUCs for TPSA, SUVmax, PI-RADSv2.1, and PRIMARY score were 0.699, 0.898, 0.878, and 0.910, respectively, with corresponding diagnostic sensitivities of 53.3%, 87.0%, 90.2%, and 83.7%, and specificities of23.0%, 65. 1%, 42.6%, and 58.5%, respectively. The predictive ROC curve analysis of the model revealed an AUC of 0.968, with 91.3% sensitivity, and 84.6% specificity. MedCalc analysis showed that the AUC of the model was superior compared with that of SUVmax, PI-RADS v2.1 Score, and the PRIMARY score. The difference was statistically significant (Z= 2.273, 3.485, 2.761; P=0.023, 0.000, 0.005).ConclusionsThe 5-grade PRIMARY score, derived from [18F]PSMA-1007 PET/CT in conjunction with the PI-RADSv2.1 score, offers enhanced discrimination of csPCa.https://www.frontiersin.org/articles/10.3389/fonc.2025.1589212/full[18 F]F-PSMA-1007positron emission tomography/computed tomographymultiparametric magnetic resonance imagingprostate cancermolecular probe
spellingShingle Zhilong Ma
HaiTong Hao
HaiTong Hao
Jian Chen
Jian Chen
Tong Pan
Tong Pan
Qian Zhao
YanMei Li
Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
Frontiers in Oncology
[18 F]F-PSMA-1007
positron emission tomography/computed tomography
multiparametric magnetic resonance imaging
prostate cancer
molecular probe
title Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
title_full Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
title_fullStr Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
title_full_unstemmed Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
title_short Diagnostic value of [18F]PSMA-1007 PET/CT based on PRIMARY score combined with mpMRI in clinically significant prostate cancer
title_sort diagnostic value of 18f psma 1007 pet ct based on primary score combined with mpmri in clinically significant prostate cancer
topic [18 F]F-PSMA-1007
positron emission tomography/computed tomography
multiparametric magnetic resonance imaging
prostate cancer
molecular probe
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1589212/full
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