Clinical Application of Prostate-specific Membrane Antigen PET/CT for Reducing Unnecessary Biopsies in Prostate Cancer
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0215
- VernacularTitle:前列腺特异性膜抗原PET/CT对减少前列腺癌过度穿刺活检的应用价值
- Author:
Jishen ZHANG
1
;
Yujie XIE
;
Ting YANG
;
Ju JIAO
;
Zhaohui HE
Author Information
1. 中山大学附属第八医院泌尿外科,广东 深圳 518033
- Publication Type:Journal Article
- Keywords:
prostate biopsy;
prostate cancer;
PET/CT;
prostate-specific membrane antigen;
prostate-specific antigen density
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(2):311-317
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To evaluate the application of prostate-specific membrane antigen(PSMA)PET/CT in prostate biopsy screening,and propose effective strategies for prostate biopsy decision making based on PSMA PET/CT detection.[Methods]A retrospective analysis was conducted on PSMA PET/CT imaging and clinical pathological data from 155 patients with suspected prostate cancer between January 2020 and December 2023.PRIMARY score was used as the standardized evaluation method for PSMA PET/CT in the diagnosis of prostate cancer.And compared the positive prostate biopsy rates,missed diagnosis rates and biopsy reduction rates were compared regarding different PRIMARY scores.Receiver operating characteristic(ROC)curves were used to analyze prostate-specific antigen(PSA)and its derived parameters and identify the most suitable supplementary screening indicators for combined use with the PRIMARY score.[Results]Among patients with PRIMARY scores of 1 to 5,the proportions of patients diagnosed with prostate cancer were 15.8%(3/19),17.1%(7/41),50%(12/24),95.2%(20/21)and 98%(49/50),respectively.Using PRIMARY score of 3-5 as the biopsy screening strategy resulted in a positive prostate biopsy rate of 85.3%and biopsy reduction rate of 38.7%,but a missed diagnosis rate of 11%.PSA density>0.15 ng/(mL·cm3)was selected as a supplementary screening criterion to detect prostate cancer from patients with PRIMARY scores of 1-2.The combined application of the above two screening criteria reduced the missed diagnosis rate to 2.2%.[Conclusion]This study proposes a novel biopsy screening strategy for suspected prostate cancer patients using PSMA PET/CT,that is,a PRIMARY score of 3-5 or a PRIMARY score of 1-2 but PSA density>0.15 ng/(mL·cm3),which can effectively avoid unnecessary biopsies and significantly reduce the missed diagnosis rate.
