2024-05-08 21:29:11
PET/MRI can therefore improve the accuracy of diagnosis for patients with prostate cancer and avoid unnecessary invasive examinations, but only on the condition that the correct scale is used.
The Prostate Imaging Reporting and Data System (PI-RADS) is a 5-point scale used to evaluate suspected prostate cancer on MRI images. PI-RADS category 3, vaguely suggestive of clinically significant prostate cancer, remains a “diagnostic challenge”. Although current guidelines recommend biopsy in this case, less than 20% of lesions classified as PI-RADS 3 correspond to clinically significant prostate cancer.
A Diagnostic Solution to the PI-RADS 3 Lesion Dilemma
“PI-RADS 3 lesions present a dilemma for both urologists and patients as biopsy is often not required immediately; however, an active surveillance strategy may lead to clinically significant prostate cancer diagnoses.”Summary of one of the lead authors, Dr. Hongqian Guo, urologist at Nanjing Hospital: “Thus, the specific exclusion of prostate cancer among PI-RADS 3 lesions has significant clinical implications. »
The study This is done on 56 men with PI-RADS 3 lesions, who received 68Ga-PSMA PET/MRI. After imaging, all patients underwent a prostate biopsy to assess whether they had clinically significant prostate cancer. These exams show:
- biopsy detected clinically significant prostate cancer in 8 of 56 patients, or 14% of participants;
- with PET/MRI, 40 of 48 participants, or 83%, could avoid unnecessary biopsies, with a risk of 1 clinically significant prostate cancer among the 8 identified by biopsy, or about 12%.
The researchers conclude that “the added value » of 68Ga-PSMA PET/MRI in the classification of PI-RADS 3 lesions and recommends that “PI-RADS 3” patients be referred in the future and as long as possible.
PET/MRI before prostate biopsy.
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