Affiliation:
1. Affiliated Drum Tower Hospital, Medical School of Nanjing University
2. Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
3. Nanjing Medical University
Abstract
Abstract
Backgroud
mpMRI-TB improves the clinically significant prostate cancer (csPCa) detection rate. However, there has been none consensus regarding the avoidance of systematic biopsy (SB) with more biopsy cores in patients undergoing mpMRI-TB. Thus, this study is to investigate the diagnostic value of 68Ga-PSMA-11 in predicting the concordance between mpMRI-TB and combined biopsy (CB) in detecting PCa.
Methods
115 consecutive men with 68Ga-PSMA-11 PET/CT prior to prostate biopsy were included for analysis. PSMA intensity, quantified as maximum standard uptake value (SUVmax), minimum apparent diffusion coefficient (ADCmin) and other clinical characteristics were evaluated relative to biopsy concordance by using univariate and multivariate logistic regression analyses. A prediction model was developed based on the identified parameters.
Results
concordance between mpMRI-TB and CB occurred in 76.5% (88/115) of the patients. Multivariate logistic regression analyses performed that SUVmax (OR = 0.952; 95% CI: 0.917–0.988; p = 0.010) and ADCmin (OR = 1.006; 95% CI: 1.003–1.010; p = 0.001) were independent risk factors for biopsy concordance. The developed model showed a sensitivity, specificity, accuracy and AUC of 0.67, 0.78, 0.81 and 0.78 in the full sample.
Conclusions
The developed prediction model based on SUVmax and ADCmin showed practical value in guiding the optimization of prostate biopsy pattern. Lower SUVmax and Higher ADCmin values are associated with greater confidence in implementing mono-TB and safely avoiding SB, effectively balancing benefits and risks.
Publisher
Research Square Platform LLC