Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial

Objective: This study aimed to compare the upgrade rate and cancer detection rate between the 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy (TB) and systematic biopsy in selected patients with suspected prostate cancer (the molecular imaging prostate-specific membrane antigen score of...

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Main Authors: Shaoxi Niu, Yachao Liu, Liyan Ao, Xiaohui Ding, Xiao Chang, Jinhang Li, Jiajin Liu, Kan Liu, Nanxing Zou, Baixuan Xu, Yong Xu, Baojun Wang, Xu Zhang
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Asian Journal of Urology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214388224001206
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author Shaoxi Niu
Yachao Liu
Liyan Ao
Xiaohui Ding
Xiao Chang
Jinhang Li
Jiajin Liu
Kan Liu
Nanxing Zou
Baixuan Xu
Yong Xu
Baojun Wang
Xu Zhang
author_facet Shaoxi Niu
Yachao Liu
Liyan Ao
Xiaohui Ding
Xiao Chang
Jinhang Li
Jiajin Liu
Kan Liu
Nanxing Zou
Baixuan Xu
Yong Xu
Baojun Wang
Xu Zhang
author_sort Shaoxi Niu
collection DOAJ
description Objective: This study aimed to compare the upgrade rate and cancer detection rate between the 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy (TB) and systematic biopsy in selected patients with suspected prostate cancer (the molecular imaging prostate-specific membrane antigen score of ≥2 and multiparametric MRI Prostate Imaging Reporting and Data System score of ≥4). Methods: Eighty-seven selected biopsy-naive patients were randomized into two groups: TB (n=41) and systematic biopsy (control; n=46). Patients diagnosed with clinically significant prostate cancer proceeded to radical prostatectomy. The primary outcome was the pathological upgrade rate. Secondary outcomes, including the cancer detection rate, incidence of repeat biopsy, positive surgical margin, complications, and prostate-specific antigen level at 6 weeks postoperatively, were compared between the groups using the Pearson or Fisher's exact test, as appropriate. Results: In the study, prostate cancer was ultimately detected in all patients. The TB group successfully identified all tumors, whereas five patients in the control group initially missed diagnosis. The pathological upgrade rates for the TB and control groups were 31.7 % and 56.5%, respectively. Overall, the detection rate for clinically significant prostate cancer (the International Society of Urological Pathology grade of ≥2) was significantly higher in the TB group (92.7%) compared with the control group (76.1%, p=0.035). However, no significant difference was found in the detection rate of all prostate cancer. Complications (Clavien–Dindo grade of ≤2) occurred in both the TB group (n=11) and control group (n=13). No statistically significant difference was observed between the groups in terms of the positive surgical margin, complications, or 6-week postoperative prostate-specific antigen level. Conclusion: The 18F-DCFPyL PET/MRI-guided ultrasound fusion TB alone was an efficient modality in diagnosing selected patients with prostate cancer.
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spelling doaj-art-28cabbe3b330412d95eb2240cc93a5362025-01-30T05:14:17ZengElsevierAsian Journal of Urology2214-38822025-01-011214350Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trialShaoxi Niu0Yachao Liu1Liyan Ao2Xiaohui Ding3Xiao Chang4Jinhang Li5Jiajin Liu6Kan Liu7Nanxing Zou8Baixuan Xu9Yong Xu10Baojun Wang11Xu Zhang12Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China; Graduate School of Chinese PLA Medical School, Beijing, ChinaDepartment of Pathology, The First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Pathology, The First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China; Graduate School of Chinese PLA Medical School, Beijing, ChinaDepartment of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China; Corresponding authors.Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China; Corresponding authors.Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, China; Corresponding authors.Objective: This study aimed to compare the upgrade rate and cancer detection rate between the 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy (TB) and systematic biopsy in selected patients with suspected prostate cancer (the molecular imaging prostate-specific membrane antigen score of ≥2 and multiparametric MRI Prostate Imaging Reporting and Data System score of ≥4). Methods: Eighty-seven selected biopsy-naive patients were randomized into two groups: TB (n=41) and systematic biopsy (control; n=46). Patients diagnosed with clinically significant prostate cancer proceeded to radical prostatectomy. The primary outcome was the pathological upgrade rate. Secondary outcomes, including the cancer detection rate, incidence of repeat biopsy, positive surgical margin, complications, and prostate-specific antigen level at 6 weeks postoperatively, were compared between the groups using the Pearson or Fisher's exact test, as appropriate. Results: In the study, prostate cancer was ultimately detected in all patients. The TB group successfully identified all tumors, whereas five patients in the control group initially missed diagnosis. The pathological upgrade rates for the TB and control groups were 31.7 % and 56.5%, respectively. Overall, the detection rate for clinically significant prostate cancer (the International Society of Urological Pathology grade of ≥2) was significantly higher in the TB group (92.7%) compared with the control group (76.1%, p=0.035). However, no significant difference was found in the detection rate of all prostate cancer. Complications (Clavien–Dindo grade of ≤2) occurred in both the TB group (n=11) and control group (n=13). No statistically significant difference was observed between the groups in terms of the positive surgical margin, complications, or 6-week postoperative prostate-specific antigen level. Conclusion: The 18F-DCFPyL PET/MRI-guided ultrasound fusion TB alone was an efficient modality in diagnosing selected patients with prostate cancer.http://www.sciencedirect.com/science/article/pii/S2214388224001206Prostatic neoplasm18F-DCFPyLPETTargeted biopsyProstate-specific membrane antigen
spellingShingle Shaoxi Niu
Yachao Liu
Liyan Ao
Xiaohui Ding
Xiao Chang
Jinhang Li
Jiajin Liu
Kan Liu
Nanxing Zou
Baixuan Xu
Yong Xu
Baojun Wang
Xu Zhang
Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
Asian Journal of Urology
Prostatic neoplasm
18F-DCFPyL
PET
Targeted biopsy
Prostate-specific membrane antigen
title Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
title_full Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
title_fullStr Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
title_full_unstemmed Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
title_short Comparison between 18F-DCFPyL PET/MRI-guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients: A prospective randomized controlled trial
title_sort comparison between 18f dcfpyl pet mri guided ultrasound fusion targeted biopsy and systematic biopsy for tumor detection and grading in selected patients a prospective randomized controlled trial
topic Prostatic neoplasm
18F-DCFPyL
PET
Targeted biopsy
Prostate-specific membrane antigen
url http://www.sciencedirect.com/science/article/pii/S2214388224001206
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