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Prostate cancer: PET/MRI to avoid 80% of unnecessary biopsies

Prostate cancer: PET/MRI to avoid 80% of unnecessary biopsies

PET/MRI therefore makes it possible to improve the diagnostic accuracy of patients with prostate cancer and avoid unnecessary invasive examinations, but provided 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, which presents an unclear suggestion of clinically significant prostate cancer, remains a “diagnostic challenge.” Although current guidelines recommend a biopsy in this setting, less than 20% of lesions classified as PI-RADS 3 are consistent with clinically significant prostate cancer.

A diagnostic solution to the PI-RADS lesion dilemma 3

“PI-RADS 3 lesions pose a dilemma for both urologists and patients because immediate biopsy is often unnecessary; however, an active surveillance strategy can also lead to missing a clinically important prostate cancer diagnosis.One of the lead authors, Dr. Hongqian Guo, a urologist at Nanjing Hospital, summarizes: “Therefore, specifically excluding prostate cancer among PI-RADS 3 lesions has significant clinical implications.”

the study It was performed in 56 men with PI-RADS 3 lesions, who underwent 68Ga-PSMA PET/MRI. After imaging, all patients underwent prostate biopsy to evaluate whether they had clinically significant prostate cancer. These tests reveal the following:

  • Clinically significant prostate cancer was detected by biopsy in 8 of 56 patients, or 14% of participants;
  • With PET/MRI, 40 of 48 participants, or 83%, were able to avoid unnecessary biopsies, putting them at risk of missing one clinically significant prostate cancer out of the eight cases identified by biopsy, or Approximately 12%.

The researchers conclude that “added value » of 68Ga-PSMA PET/MRI in the classification of PI-RADS 3 lesions and it was suggested that “PI-RADS 3” patients be referred in the future and as much as possible to

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PET/MRI before prostate biopsy.