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Mondia MWL, Batchala PP, Dreicer R, Devitt ME, McCord MR, Mut M, Sheehan JP, Schiff D, Fadul CE. Incidental Brain Metastases From Prostate Cancer Diagnosed With PSMA PET/CT and MRI: A Case Series and Literature Review. Prostate 2025; 85:841-849. [PMID: 40079497 PMCID: PMC12068031 DOI: 10.1002/pros.24890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 02/21/2025] [Accepted: 03/04/2025] [Indexed: 03/15/2025]
Abstract
BACKGROUND Brain metastases (BMETS) from prostate cancer are rare. Hence, brain imaging in neurologically asymptomatic patients with advanced prostate cancer (aPC) is not routinely performed. Prostate-specific membrane antigen (PSMA) PET/CT uses a radiotracer that binds to prostate cancer epithelial cells and is FDA-approved for initial staging for high-risk prostate cancer, detecting prostate cancer recurrence, and determining eligibility for radionuclide therapy. METHODS We report six patients with asymptomatic BMETS from aPC found on staging PSMA PET/CT or MRI. Along with cranial MRI, PSMA PET/CT may be useful for detecting asymptomatic intracranial metastasis in select patients with prostate cancer. RESULTS Brain metastases were diagnosed in four patients by staging PSMA PET/CT scan-three after systemic disease progression and one during routine surveillance. In two other patients, BMETS were detected using MRI despite negative PSMA PET/CT for brain lesions. All were neurologically asymptomatic. Three patients had undetectable serum prostate-specific antigen (PSA) concentrations; one had neuroendocrine differentiation on histology. CONCLUSION In patients with poorly differentiated or neuroendocrine aPC, BMETS may occur without neurologic symptoms and stable PSA. PSMA PET/CT may complement brain MRI for identifying BMETS in these patients.
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Affiliation(s)
- Mark Willy L. Mondia
- Division of Neuro‐Oncology, Department of NeurologyUniversity of VirginiaCharlottesvilleVirginia
| | - Prem P. Batchala
- Division of Nuclear Medicine, Department of Radiology and Medical ImagingUniversity of VirginiaCharlottesvilleVirginia
| | - Robert Dreicer
- Division of Hematology/Oncology, Departments of Medicine and UrologyUniversity of VirginiaCharlottesvilleVirginia
| | - Michael E. Devitt
- Division of Hematology/Oncology, Departments of Medicine and UrologyUniversity of VirginiaCharlottesvilleVirginia
| | - Matthew R. McCord
- Department of PathologyUniversity of VirginiaCharlottesvilleVirginia
| | - Melike Mut
- Department of NeurosurgeryUniversity of VirginiaCharlottesvilleVirginia
| | - Jason P. Sheehan
- Department of NeurosurgeryUniversity of VirginiaCharlottesvilleVirginia
| | - David Schiff
- Division of Neuro‐Oncology, Department of NeurologyUniversity of VirginiaCharlottesvilleVirginia
| | - Camilo E. Fadul
- Division of Neuro‐Oncology, Department of NeurologyUniversity of VirginiaCharlottesvilleVirginia
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Raeisi N, Saber Tanha A, Sadeghi R, Dorri Giv M, Dabbagh Kakhki VR. Prostate Adenocarcinoma Recurrence in the Vas Deferens Unveiled by 99mTc-PSMA SPECT/CT Imaging. Clin Nucl Med 2025:00003072-990000000-01705. [PMID: 40357624 DOI: 10.1097/rlu.0000000000005881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 02/26/2025] [Indexed: 05/15/2025]
Abstract
We present a case involving a 77-year-old man with prostate cancer who underwent radical prostatectomy with negative surgical margins. After 10 years without follow-up, his serum prostate-specific antigen level increased to 2.76 ng/mL, suggesting disease recurrence. Due to limited access to 68Ga-PSMA PET/CT, a 99mTc-HYNIC-PSMA SPECT/CT was conducted, which identified PSMA uptake in the bilateral vas deferens, a rare site for recurrence. While recurrence in the vas deferens has been previously reported using 68Ga-PSMA PET/CT or PET/MR, this novel experience with 99mTc-PSMA SPECT/CT highlights its potential utility in detecting such recurrences. This is particularly relevant in low-income countries where access to PET/CT may be limited.
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Affiliation(s)
- Nasrin Raeisi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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3
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Qin J, Zhou D, Su M, Huang S, Nong Q, Xian X, Zhang Z. Proteomic hub proteins CDKN2B, TRAPPC2L, WFS1, and ARPP19 drive biochemical recurrence and metastatic progression in prostate cancer: Protein macromolecule action. Int J Biol Macromol 2025; 311:144059. [PMID: 40345286 DOI: 10.1016/j.ijbiomac.2025.144059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2025] [Revised: 05/02/2025] [Accepted: 05/07/2025] [Indexed: 05/11/2025]
Abstract
The biological characteristics and metastasis mechanism of prostate cancer are complex, involving the important role of many proteins in cell transcriptional regulation. This study focused on the role of the proteomic hub proteins CDKN2B, TRAPPC2L, WFS1 and ARPP19 in the biochemical recurrence and metastasis progression of prostate cancer. Cross-platform transcriptome integration and differential expression analysis were used to evaluate transcriptome characteristics in a prostate cancer cohort. Functional enrichment analysis was performed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway annotation, and weighted gene co-expression network analysis (WGCNA) was used to investigate cancer progression subtypes. It was found that prostate cancer progression showed significant transcriptome heterogeneity, and low-expression genes dominated. We reveal the important role of epithelial-immune interactions and inflammatory signaling in transcriptional remodeling in prostate cancer. The co-expression network topology analysis showed that the immune-metabolic center module plays a central role in cancer progression. CDKN2B was identified as a key transcriptional determinant in prostate cancer typing, while TRAPPC2L and WFS1 acted as core transcriptional regulators, driving metastatic heterogeneity. ARPP19 and LOC650152 also show important transcriptional driving effects in advanced prostate cancer.
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Affiliation(s)
- Junkai Qin
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Dapeng Zhou
- Department of Burn Plastic and Wound Repair Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities and Key Laboratory of Molecular Pathology in Tumors of Baise, Baise 533000, China
| | - Mingchang Su
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Siyuan Huang
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Qian Nong
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Xiaoying Xian
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China.
| | - Zhifu Zhang
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China.
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Gomis-Sellés E, Maldonado A, Gaztañaga M, Vera V, Ajulia O, Sancho G, Siva S, Lopez-Campos F, Couñago F. Impact of PSMA-PET/CT on Radiotherapy Decisions: Is There a Clinical Benefit? Cancers (Basel) 2025; 17:1350. [PMID: 40282526 PMCID: PMC12025452 DOI: 10.3390/cancers17081350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Revised: 04/11/2025] [Accepted: 04/14/2025] [Indexed: 04/29/2025] Open
Abstract
Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) has emerged as a game-changing imaging modality in prostate cancer, offering superior sensitivity and specificity compared to conventional imaging techniques. Its increasing adoption has significantly influenced radiotherapy decision-making, yet its true clinical impact remains under investigation. This narrative review explores the role of PSMA-PET/CT in guiding radiotherapy decisions across different clinical scenarios, from primary treatment planning to biochemical recurrence and oligometastatic disease. We assess its impact on target delineation, treatment modifications, and overall patient management while addressing existing knowledge gaps.
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Affiliation(s)
- Elías Gomis-Sellés
- Department of Radiation Oncology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
| | - Antonio Maldonado
- Nuclear Medicine and Molecular Imaging Department, University Hospital Quironsalud Madrid/La Luz Hospital, 28003 Madrid, Spain;
| | - Miren Gaztañaga
- Department of Radiation Oncology, San Carlos Hospital, Genesis Care Vithas La Milagrosa, 28010 Madrid, Spain;
| | - Victoria Vera
- Department of Radiation Oncology, Badajoz University Hospital, 06006 Badajoz, Spain;
| | - Odile Ajulia
- Nuclear Medicine Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain;
| | - Gemma Sancho
- Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain;
| | - Shankar Siva
- Peter MacCallum Cancer Centre, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville 3010, Australia;
| | - Fernando Lopez-Campos
- Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Genesis Care Vithas La Milagrosa, 28010 Madrid, Spain;
| | - Felipe Couñago
- Genesiscare España, Hospital Universitario San Francisco de Asis, Hospital Universitario La Milagrosa, Universidad Europea de Madrid, 28670 Madrid, Spain;
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Dong Y, Wang P, Geng H, Liu Y, Wang E. Ultrasound and advanced imaging techniques in prostate cancer diagnosis: A comparative study of mpMRI, TRUS, and PET/CT. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2025; 33:436-447. [PMID: 39973788 DOI: 10.1177/08953996241304988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Abstract
ObjectiveThis study aims to assess and compare the diagnostic performance of three advanced imaging modalities-multiparametric magnetic resonance imaging (mpMRI), transrectal ultrasound (TRUS), and positron emission tomography/computed tomography (PET/CT)-in detecting prostate cancer in patients with elevated PSA levels and abnormal DRE findings.MethodsA retrospective analysis was conducted on 150 male patients aged 50-75 years with elevated PSA and abnormal DRE. The diagnostic accuracy of each modality was assessed through sensitivity, specificity, and the area under the curve (AUC) to compare performance in detecting clinically significant prostate cancer (Gleason score ≥ 7).ResultsMpMRI demonstrated the highest diagnostic performance, with a sensitivity of 90%, specificity of 85%, and AUC of 0.92, outperforming both TRUS (sensitivity 76%, specificity 78%, AUC 0.77) and PET/CT (sensitivity 82%, specificity 80%, AUC 0.81). MpMRI detected clinically significant tumors in 80% of cases. Although TRUS and PET/CT had similar detection rates for significant tumors, their overall accuracy was lower. Minor adverse events occurred in 5% of patients undergoing TRUS, while no significant complications were associated with mpMRI or PET/CT.ConclusionThese findings suggest that mpMRI is the most reliable imaging modality for early detection of clinically significant prostate cancer. It reduces the need for unnecessary biopsies and optimizes patient management.
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Affiliation(s)
- Ying Dong
- Department of Radiology, Beijing Renhe Hospital, Beijing, China
| | - Peng Wang
- Department of Imaging Diagnostic, Binzhou Hospital of Traditional Chinese Medicine, Binzhou City, China
| | - Hua Geng
- Department of Oncology, Binzhou Hospital of Traditional Chinese Medicine, Binzhou City, China
| | - Yankun Liu
- Department of Medical Imaging Center, Central Hospital Afffliated to Shandong First Medical University, Jinan City, China
| | - Enguo Wang
- Department of Medical Imaging Center, Central Hospital Afffliated to Shandong First Medical University, Jinan City, China
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Antunes PDM, Sabaneeff N, Correia ETDO, Bittencourt LK. Prostate Imaging for Recurrence Reporting System Made Easy: A Case-Based Review of Prostate Cancer Local Recurrence on Magnetic Resonance Imaging. Semin Ultrasound CT MR 2025; 46:56-70. [PMID: 39580038 DOI: 10.1053/j.sult.2024.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2024]
Abstract
Prostate cancer (PCa) is one of the most prevalent cancers worldwide. Even following appropriate initial treatments, a subset of the patients develops tumor recurrence. Magnetic resonance imaging (MRI) is pivotal in investigating local recurrence, but its performance is limited in detecting recurrence at other sites (especially in subcentimeter lymph nodes). Recently, an expert consensus proposed a scoring system for MRI-based assessment of local recurrence, called prostate imaging for recurrence reporting system (PI-RR). This case-based review describes the expected post-treatment changes and MRI findings of local PCa recurrence after RP and RT.
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Affiliation(s)
- Paulo de Moraes Antunes
- Department of Radiology, Américas Serviços Médicos, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Radiology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
| | - Natalia Sabaneeff
- Department of Radiology, Américas Serviços Médicos, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Radiology, Diagnósticos das Américas (DASA), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Leonardo Kayat Bittencourt
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Case Western Reserve University, Cleveland, OH
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Nisar MU, Purysko AS, Ward RD. Posttreatment Lower Urinary Tract and Prostate Imaging. Urol Clin North Am 2025; 52:153-167. [PMID: 39537301 DOI: 10.1016/j.ucl.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
The treatment of benign and malignant diseases of the lower urinary tract and prostate gland can alter the anatomy and physiology of these regions. The radiologist should be familiar with the commonly performed procedures for conditions affecting the lower urinary tract as well as the expected and unexpected posttreatment appearance on imaging.
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Affiliation(s)
- Muhammad Umer Nisar
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Andrei S Purysko
- Division of Abdominal Imaging, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Ryan D Ward
- Division of Abdominal Imaging, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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von Stauffenberg F, Poyet C, Beintner-Skawran S, Maurer A, Schmid FA. Current Clinical Applications of PSMA-PET for Prostate Cancer Diagnosis, Staging, and Treatment. Cancers (Basel) 2024; 16:4263. [PMID: 39766162 PMCID: PMC11674651 DOI: 10.3390/cancers16244263] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 12/19/2024] [Accepted: 12/20/2024] [Indexed: 01/11/2025] Open
Abstract
Over the past decade, prostate-specific membrane antigen positron emission tomography (PSMA-PET) has revolutionized prostate cancer (PCa) imaging, offering greater sensitivity and specificity compared to conventional imaging modalities such as CT, MRI, and bone scintigraphy. PSMA-PET is particularly valuable in staging newly diagnosed patients with intermediate- and high-risk disease, detecting biochemical recurrence, and evaluating metastatic cases. By utilizing radiotracers that accumulate specifically in PSMA-expressing cells, even small metastases can be detected, offering a detailed assessment of cancer extent and enabling more targeted diagnostic evaluations. Among the most utilized radiotracers, [68Ga]- and [18F]-labeled PSMA tracers enable precise imaging even with low disease burden. This diagnostic precision also supports advanced therapeutic approaches, including metastasis-directed therapy for oligometastatic cases and systemic treatment options, such as radioligand therapy, which presents new treatment perspectives for metastatic, castration-resistant PCa. This review examines the evolution of PSMA-PET in the diagnostics and therapy of PCa while comparing the current recommendations from leading clinical guidelines. The integration of PSMA-PET into clinical practice has redefined the management of PCa, improving diagnostic accuracy and enabling personalized treatment strategies, while lacking prospective long-term outcome data. As PSMA-PET continues to expand in clinical application, this review highlights its significant advancements while critically addressing limitations to ensure balanced and evidence-based implementation in prostate cancer care.
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Affiliation(s)
- Franz von Stauffenberg
- Department of Urology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Cédric Poyet
- Department of Urology, Stadtspital Triemli, 8063 Zurich, Switzerland;
| | - Stephan Beintner-Skawran
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.B.-S.); (A.M.)
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.B.-S.); (A.M.)
| | - Florian A. Schmid
- Department of Urology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
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Li A, Shen K, Ji Y, Zhang W, Liu B, Su R, Zhou X, Dong L, Zhu Y, Dong B, Pan J, Wang Q, Xue W. Prognostic value of [ 18F]FDG PET/CT in metastatic hormone-sensitive prostate cancer at initial diagnosis: a retrospective cohort study. Ann Med 2024; 56:2411017. [PMID: 39392016 PMCID: PMC11485890 DOI: 10.1080/07853890.2024.2411017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/07/2024] [Accepted: 09/17/2024] [Indexed: 10/12/2024] Open
Abstract
INTRODUCTION This retrospective study aimed to evaluate the prognostic value of [18F]FDG parameters in patients with visceral and bone metastatic hormone-sensitive prostate cancer (mHSPC). PATIENTS AND METHODS This analysis included the mHSPC patients who underwent [18F]FDG PET/CT at the initial diagnosis. Baseline characteristics were analyzed, and the uptake of [18F]FDG was quantified using SUVmax. Kaplan-Meier and Cox proportional hazard regression analysis were employed to evaluate the correlation between SUVmax and patient survival. RESULTS Among the 267 patients enrolled, 90 (33.7%) presented with visceral metastases and 177 (66.3%) had bone metastases. The median follow-up for the visceral metastasis group was 35.5 months (IQR 26-53.8 months). The median overall survival for patients with lung, liver, or both metastases were 30, 21 and 17 months, respectively. Patients exhibiting higher [18F]FDG uptake in metastatic lesions experienced shorter overall survival (OS) in comparison to those with lower [18F]FDG uptake, both in the visceral metastases group (17 vs. 31 months, p = 0.002) and the bone metastases group (27.5 vs. 34.5 months, p < 0.001). Cox regression analysis further revealed that increased [18F]FDG uptake in metastatic lesions emerged as a significant risk factor in both OS and progression-free survival (PFS). In contrast, the variability in [18F]FDG uptake in primary lesions did not provide a reliable indicator for predicting prognosis. CONCLUSIONS In mHSPC patients, higher [18F]FDG uptake in metastatic lesions indicates shorter survival and increased risk of disease progression. The [18F]FDG SUVmax in primary tumors did not show significant prognostic value. Our study underscores the unique prognostic potential of [18F]FDG PET/CT in mHSPC patients, highlighting its importance in the management of both bone and visceral metastases.
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Affiliation(s)
- Ang Li
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kai Shen
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiyi Ji
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Zhang
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bo Liu
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruopeng Su
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Zhou
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Dong
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinjie Zhu
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baijun Dong
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiahua Pan
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Wang
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Tumor Microenvironment and Inflammation, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Xue
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kohan A, Hanneman K, Mirshahvalad SA, Afaq A, Mallak N, Metser U, Veit-Haibach P. Current Applications of PET/MR: Part II: Clinical Applications II. Can Assoc Radiol J 2024; 75:826-837. [PMID: 38836428 DOI: 10.1177/08465371241255904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Due to the major improvements in the hardware and image reconstruction algorithms, positron emission tomography/magnetic resonance imaging (PET/MR) is now a reliable state-of-the-art hybrid modality in medical practice. Currently, it can provide a broad range of advantages in preclinical and clinical imaging compared to single-modality imaging. In the second part of this review, we discussed the further clinical applications of PET/MR. In the chest, PET/MR has particular potential in the oncology setting, especially when utilizing ultrashort/zero echo time MR sequences. Furthermore, cardiac PET/MR can provide reliable information in evaluating myocardial inflammation, cardiac amyloidosis, myocardial perfusion, myocardial viability, atherosclerotic plaque, and cardiac masses. In gastrointestinal and hepato-pancreato-biliary malignancies, PET/MR is able to precisely detect metastases to the liver, being superior over the other imaging modalities. In genitourinary and gynaecology applications, PET/MR is a comprehensive diagnostic method, especially in prostate, endometrial, and cervical cancers. Its simultaneous acquisition has been shown to outperform other imaging techniques for the detection of pelvic nodal metastases and is also a reliable modality in radiation planning. Lastly, in haematologic malignancies, PET/MR can significantly enhance lymphoma diagnosis, particularly in detecting extra-nodal involvement. It can also comprehensively assess treatment-induced changes. Furthermore, PET/MR may soon become a routine in multiple myeloma management, being a one-stop shop for evaluating bone, bone marrow, and soft tissues.
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Affiliation(s)
- Andres Kohan
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Kate Hanneman
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Seyed Ali Mirshahvalad
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Asim Afaq
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nadine Mallak
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Ur Metser
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Patrick Veit-Haibach
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Ji G, Liu F, Chen Z, Peng J, Deng H, Xiao S, Li Y. Correlation of Magnetic Resonance Imaging and Computed Tomography with Biological Factor Expression and Lymph Node Metastasis in Aggressive Prostate Cancer. Urol Int 2024; 109:175-181. [PMID: 39462504 DOI: 10.1159/000541953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 10/08/2024] [Indexed: 10/29/2024]
Abstract
INTRODUCTION This article focused on probing the correlation of magnetic resonance imaging (MRI) and computed tomography (CT) manifestations with biological factor expression and lymph node metastasis (LNM) in aggressive prostate cancer (PCa). METHODS A total of 136 PCa patients underwent surgical treatment and received CT and MRI examinations before surgery, whereby the apparent diffusion coefficient (ADC) values of quantitative MRI (qMRI) parameters were obtained. Patients were categorized into the non-aggressive PCa group and the aggressive PCa group according to the postoperative pathological results and Gleason scores. The expression of biological factors (prostate-specific antigen [PSA], proliferating cell nuclear antigen [PCNA], p27, and Ki-67) in both groups was tested. CT and MRI manifestations of aggressive PCa patients were analyzed. The qMRI parameters, biological factors levels, and LNM were compared in two groups; the relationships between CT and MRI manifestations, qMRI parameters, and positive expression of biological factors and LNM were probed in two groups. RESULTS In the aggressive PCa group, MRI and CT presented different degrees of abnormal prostate changes. In the aggressive PCa group, PSA and p27 expression and ADC values were lower, and PCNA and Ki-67, and LNM rates were higher. Patients' LNM rate was higher than that of ≤2 cm when the tumor diameter was >2 cm. ADC values were positively correlated with PSA and p27 positive expression and negatively correlated with PCNA, Ki-67, and LNM in the aggressive PCa group. CONCLUSION MRI and CT manifestations of aggressive PCa had certain characteristics; MRI manifestations and qMRI possessed a correlation with biological factors and LNM; ADC could be employed to assess the aggressiveness of PCa.
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Affiliation(s)
- Guanghai Ji
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Fei Liu
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Zhiqing Chen
- Department of Radiology, The First Hospital Affiliated of Hainan Medical University, Haikou, China
| | - Jie Peng
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Hao Deng
- Department of Urology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Sheng Xiao
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Yun Li
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
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Virarkar MK, Gruschkus SK, Ravizzini GC, Vulasala SSR, Javadi S, Bhosale P. Assessing the effectiveness of MRI, 18F-fluciclovine PET, SUV max, and PSA in detecting local recurrence of prostate cancer after prostatectomy. Pol J Radiol 2024; 89:e196-e203. [PMID: 38783912 PMCID: PMC11112415 DOI: 10.5114/pjr.2024.139007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/12/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose The primary objective of this study was to evaluate the discriminatory utility of magnetic resonance imaging (MRI), 18F-fluciclovine positron emission tomography (PET), maximum standardized uptake value (SUVmax), prostate-specific antigen (PSA), and combinations of these diagnostic modalities for detecting local prostate cancer recurrence in the setting of rising PSA after radical prostatectomy. Material and methods Patients were characterised for clinical features such as Gleason score, PSA at surgery, PSA at follow-up, follow-up MRI result, follow-up PET result, follow-up SUVmax, and follow-up disease status. The utility of diagnostic parameters for detecting disease recurrence at the prostatectomy bed was assessed using receiver operating characteristics (ROC) analysis to determine the area under the curve (AUC) for each model. Sensitivity, specificity, and positive/negative predictive values were also calculated. Optimal cut-off points for continuous variables were determined based on maximum Youden's J statistics. Results The study found that MRI had the highest concordance (96%), sensitivity (100%), specificity (91%), positive predictive value (93%), and negative predictive value (100%) among the diagnostic modalities. The AUC for MRI was 0.9545, indicating a high discriminatory ability for detecting prostate cancer local recurrence. When combined, PET and SUVmax (cut-off value of 2.85) showed an improved performance compared to using them individually, with an AUC of 0.8925. Conclusions The analysis suggests that MRI is the most effective imaging modality for detecting local prostate cancer recurrence, with 18F-fluciclovine PET and SUVmax also showing promising combined results. PSA has moderate discriminatory utility at follow-up but can still provide valuable information in detecting prostate cancer recurrence. Further research and recent references are needed to support these findings.
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Affiliation(s)
- Mayur K. Virarkar
- Department of Diagnostic Radiology, University of Florida College of Medicine, Jacksonville, USA
| | - Stephen K. Gruschkus
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Gregory C. Ravizzini
- Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sai Swarupa R. Vulasala
- Department of Diagnostic Radiology, University of Florida College of Medicine, Jacksonville, USA
| | - Sanaz Javadi
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Priya Bhosale
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
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Turkbey B. Invited Commentary: Advanced Anatomic and Molecular Imaging in Recurrent Prostate Cancer. Radiographics 2023; 43:e230215. [PMID: 37999985 PMCID: PMC10716665 DOI: 10.1148/rg.230215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 11/26/2023]
Affiliation(s)
- Baris Turkbey
- From the Molecular Imaging Branch, National Cancer Institute,
National Institutes of Health, 10 Center Dr, Room B3B85, Bethesda, MD
20892
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