The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis

Objectives. The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging. Methods. This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were sta...

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Main Authors: Laura Evangelista, Priscilla Guglielmo, Giulia Giacoppo, Lucia Setti, Demetrio Aricò, Lorenzo Muraglia, Katia Marzo, Nicolò Buffi, Vittorio Fasulo, Marcello Rodari, Jelena Jandric, Antonio Salvaggio, Manuela Bonacina, Massimo Lazzeri, Giovanni Lughezzani
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Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/23/2751
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author Laura Evangelista
Priscilla Guglielmo
Giulia Giacoppo
Lucia Setti
Demetrio Aricò
Lorenzo Muraglia
Katia Marzo
Nicolò Buffi
Vittorio Fasulo
Marcello Rodari
Jelena Jandric
Antonio Salvaggio
Manuela Bonacina
Massimo Lazzeri
Giovanni Lughezzani
author_facet Laura Evangelista
Priscilla Guglielmo
Giulia Giacoppo
Lucia Setti
Demetrio Aricò
Lorenzo Muraglia
Katia Marzo
Nicolò Buffi
Vittorio Fasulo
Marcello Rodari
Jelena Jandric
Antonio Salvaggio
Manuela Bonacina
Massimo Lazzeri
Giovanni Lughezzani
author_sort Laura Evangelista
collection DOAJ
description Objectives. The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging. Methods. This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were staged using radiolabeled PSMA PET/CT to evaluate the extent of the disease before initiating appropriate treatment. The study included patients from the Nuclear Medicine Units of the Humanitas group between 2021 and 2024. The change in management due to the PSMA PET/CT examination was assessed. Results. A total of 181 patients were enrolled across all three centers. Histopathological assessment from biopsy revealed that 51.4% of patients had favorable PCa, while 48.6% had unfavorable disease. PET/CT was positive for the primary lesions in all patients, but it revealed a positivity rate in 23 (12.7%) patients for nodes and distant organs, with a positivity rate of 0.21 in the unfavorable group and 0.05 in the favorable group (<i>p</i> < 0.005). Based on follow-up data, diagnostic accuracy was higher than 90% in both the favorable and unfavorable groups for lymph node and distant metastases. The inclusion of PSMA PET/CT in the diagnostic algorithm for patients with intermediate-risk PCa impacted patient management in 24 (13.3%) cases, based on the multidisciplinary team decision. Conclusions. PSMA PET/CT can affect the management of patients with intermediate-risk PCa in up to 13% of cases, mainly for unfavorable diseases. New imaging techniques as a first-line imaging procedure can help to plan the correct therapeutic approach in the intermediate-risk PCa group.
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spelling doaj-art-74ecf3a734524fe282d989424ff5b2ca2025-08-20T01:55:34ZengMDPI AGDiagnostics2075-44182024-12-011423275110.3390/diagnostics14232751The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter AnalysisLaura Evangelista0Priscilla Guglielmo1Giulia Giacoppo2Lucia Setti3Demetrio Aricò4Lorenzo Muraglia5Katia Marzo6Nicolò Buffi7Vittorio Fasulo8Marcello Rodari9Jelena Jandric10Antonio Salvaggio11Manuela Bonacina12Massimo Lazzeri13Giovanni Lughezzani14Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyNuclear Medicine Unit, Humanitas Gavazzeni, 24125 Bergamo, ItalyNuclear Medicine Unit, Humanitas Istituto Clinico Catanese, 95045 Misterbianco, ItalyNuclear Medicine Unit, Humanitas Gavazzeni, 24125 Bergamo, ItalyNuclear Medicine Unit, Humanitas Istituto Clinico Catanese, 95045 Misterbianco, ItalyNuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyNuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, ItalyNuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyNuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyUrology Unit, Humanitas Istituto Clinico Catanese, 95045 Catania, ItalyNuclear Medicine Unit, Humanitas Gavazzeni, 24125 Bergamo, ItalyUrology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, ItalyObjectives. The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging. Methods. This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were staged using radiolabeled PSMA PET/CT to evaluate the extent of the disease before initiating appropriate treatment. The study included patients from the Nuclear Medicine Units of the Humanitas group between 2021 and 2024. The change in management due to the PSMA PET/CT examination was assessed. Results. A total of 181 patients were enrolled across all three centers. Histopathological assessment from biopsy revealed that 51.4% of patients had favorable PCa, while 48.6% had unfavorable disease. PET/CT was positive for the primary lesions in all patients, but it revealed a positivity rate in 23 (12.7%) patients for nodes and distant organs, with a positivity rate of 0.21 in the unfavorable group and 0.05 in the favorable group (<i>p</i> < 0.005). Based on follow-up data, diagnostic accuracy was higher than 90% in both the favorable and unfavorable groups for lymph node and distant metastases. The inclusion of PSMA PET/CT in the diagnostic algorithm for patients with intermediate-risk PCa impacted patient management in 24 (13.3%) cases, based on the multidisciplinary team decision. Conclusions. PSMA PET/CT can affect the management of patients with intermediate-risk PCa in up to 13% of cases, mainly for unfavorable diseases. New imaging techniques as a first-line imaging procedure can help to plan the correct therapeutic approach in the intermediate-risk PCa group.https://www.mdpi.com/2075-4418/14/23/2751prostate cancerintermediate riskPSMA PET/CTdiagnostic performancechange in management
spellingShingle Laura Evangelista
Priscilla Guglielmo
Giulia Giacoppo
Lucia Setti
Demetrio Aricò
Lorenzo Muraglia
Katia Marzo
Nicolò Buffi
Vittorio Fasulo
Marcello Rodari
Jelena Jandric
Antonio Salvaggio
Manuela Bonacina
Massimo Lazzeri
Giovanni Lughezzani
The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
Diagnostics
prostate cancer
intermediate risk
PSMA PET/CT
diagnostic performance
change in management
title The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
title_full The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
title_fullStr The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
title_full_unstemmed The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
title_short The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis
title_sort evaluation of radiolabeled prostate specific membrane antigen positron emission tomography computed tomography for initial staging in intermediate risk prostate cancer patients a retrospective multicenter analysis
topic prostate cancer
intermediate risk
PSMA PET/CT
diagnostic performance
change in management
url https://www.mdpi.com/2075-4418/14/23/2751
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