Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18F-Labeled Prostate-Specific Membrane Antigen-Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm Trial.
J Urol
; 212(2): 280-289, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38885328
ABSTRACT
PURPOSE:
This study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy. MATERIALS ANDMETHODS:
Patients with a rising PSA level ranging from 4 to 30 ng/mL were scheduled for multiparametric (mp) MRI and 18F-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET). Forty-seven patients (cT2N0M0) with Prostate Imaging Reporting and Data System ≥ 4 and molecular imaging PSMA score ≥ 2 were enrolled. All candidates underwent robot-assisted laparoscopic radical prostatectomy without biopsy. Prostate cancer detection rate, index tumors localization correspondence rate, positive surgical margin, complications, postoperative hospital stay, and PSA level in a 6-week postoperative follow-up visit were collected.RESULTS:
All the patients with positive mpMRI and PSMA PET were diagnosed with clinically significant prostate cancer. A total of 80 lesions were verified as cancer by pathology, of which 63 cancer lesions were clinically significant prostate cancer. Fifty-one lesions were simultaneously found by mpMRI and PSMA PET. A total of 23 lesions were invisible on either image, and all lesions were ≤ International Society of Urological Pathology 2 or ≤ 15 mm. Forty-five (95.7%) index tumors found by mpMRI combined with PSMA PET were consistent with pathology. Nine patients reported positive surgical margin.CONCLUSIONS:
Biopsy-free prostatectomy is safe and feasible for patients with evaluation strictly by mpMRI combined with 18F-PSMA PET/CT.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Prostatectomia
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Neoplasias da Próstata
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Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
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Imageamento por Ressonância Magnética Multiparamétrica
Limite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Urol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China