Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18 F-Labeled Prostate-Specific Membrane Antigen–Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm Trial

No AccessJournal of UrologyAdult Urology17 Jun 2024Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18F-Labeled Prostate-Specific Membrane Antigen–Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm TrialThis article is commented on by the following:Editorial Comment Shaoxi Niu, Xiaohui Ding, Baichuan Liu, Liyan Ao, Haiyi Wang, Wei Chen, Baixuan Xu, Alberto Olivero, Jiajin Liu, Jiangping Gao, Yu Gao, Weijun Fu, Xin Ma, Hongzhao Li, Baojun Wang, Yachao Liu, and Xu Zhang Shaoxi NiuShaoxi Niu Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Xiaohui DingXiaohui Ding Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China , Baichuan LiuBaichuan Liu Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China Chinese PLA Medical School, Beijing, China , Liyan AoLiyan Ao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China Chinese PLA Medical School, Beijing, China , Haiyi WangHaiyi Wang Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China , Wei ChenWei Chen Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China , Baixuan XuBaixuan Xu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China , Alberto OliveroAlberto Olivero Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy , Jiajin LiuJiajin Liu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China , Jiangping GaoJiangping Gao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Yu GaoYu Gao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Weijun FuWeijun Fu Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Xin MaXin Ma Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Hongzhao LiHongzhao Li Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Baojun WangBaojun Wang Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China , Yachao LiuYachao Liu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China , and Xu ZhangXu Zhang Corresponding Author: Xu Zhang, PhD, Department of Urology, the Third Medical Centre, Chinese PLA General Hospital, 69 Yong Ding Rd, Beijing, 100039, China ([email protected]) View All Author Informationhttps://doi.org/10.1097/JU.0000000000004025AboutFull TextPDF Cite Export CitationSelect Citation formatNLMIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: This study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy. Materials and Methods: Patients with a rising PSA level ranging from 4 to 30 ng/mL were scheduled for multiparametric (mp) MRI and 18F-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET). Forty-seven patients (cT2N0M0) with Prostate Imaging Reporting and Data System ≥ 4 and molecular imaging PSMA score ≥ 2 were enrolled. All candidates underwent robot-assisted laparoscopic radical prostatectomy without biopsy. Prostate cancer detection rate, index tumors localization correspondence rate, positive surgical margin, complications, postoperative hospital stay, and PSA level in a 6-week postoperative follow-up visit were collected. Results: All the patients with positive mpMRI and PSMA PET were diagnosed with clinically significant prostate cancer. A total of 80 lesions were verified as cancer by pathology, of which 63 cancer lesions were clinically significant prostate cancer. Fifty-one lesions were simultaneously found by mpMRI and PSMA PET. A total of 23 lesions were invisible on either image, and all lesions were ≤ International Society of Urological Pathology 2 or ≤ 15 mm. Forty-five (95.7%) index tumors found by mpMRI combined with PSMA PET were consistent with pathology. Nine patients reported positive surgical margin. Conclusions: Biopsy-free prostatectomy is safe and feasible for patients with evaluation strictly by mpMRI combined with 18F-PSMA PET/CT. REFERENCES 1. . Complications after systematic, random, and image-guided prostate biopsy. Eur Urol.2017; 71(3):353-365. doi: 10.1016/j.eururo.2016.08.004 Crossref, Medline, Google Scholar 2. . The effect of different types of prostate biopsy techniques on post-biopsy infectious complications. J Urol.2022; 208(1):109-118. doi: 10.1097/JU.0000000000002497 Link, Google Scholar 3. . Prostate biopsy: guidelines and evidence. Curr Opin Urol.2018; 28(4):354-359. doi: 10.1097/MOU.0000000000000510 Crossref, Medline, Google Scholar 4. . 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J Nucl Med.2021; 62(2):208-213. doi: 10.2967/jnumed.120.246363 Crossref, Medline, Google Scholar Funding/Support: This project was supported by the Outstanding Youth Training Program and the Project of Construction of Precision Diagnosis and Treatment Technology System for Prostate Cancer in Elderly Population (21BJZ27) of PLA General Hospital. The sponsor played a role in the design and conduct of the study, data collection, and preparation of the manuscript. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. S2021-565-01). All human subjects provided written informed consent with guarantees of confidentiality. Author contributions: Conception and design: Zhang, Niu, Ao, Xu, Olivero, J. Gao, Fu, Ma, Li, B. Wang, Y. Liu. Data analysis and interpretation: Niu, B. Liu, Ao, H. Wang, Fu, Y. Liu. Data acquisition: Niu, Ding, B. Liu, Ao, Chen, J. Liu, Y. Gao, Fu, Drafting the manuscript: Zhang, Niu, Ding, B. Liu, Ao, Y. Liu, B. Wang; Y. Liu. Critical revision of the manuscript for scientific and factual content: Ao, H. Wang, Chen, Xu, Olivero, J. Liu, J. Gao, Y. Gao, Fu, Ma, Li, Y. Liu. Statistical analysis: Niu, Ding, B. Liu, Ao. Supervision: Zhang, Ao, H. Wang, Xu, Olivero, J. Liu, J. Gao, Fu, Ma, Li, B. Wang, Y. Liu. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBest O and Patel M Editorial CommentJournal of Urology, Siemens D and Routh J Editors' ChoiceJournal of Urology, Related articlesJournal of Urology17 Jun 2024Editorial Comment Supplementary Materials Peer Review Report Open Peer Review Report Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Keywordsbiopsymultiparametric magnetic resonance imagingprostate cancer positron emission tomographyradical prostatectomyMetrics Author Information Shaoxi Niu Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China Equal study contribution. More articles by this author Xiaohui Ding Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China Equal study contribution. More articles by this author Baichuan Liu Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China Chinese PLA Medical School, Beijing, China Equal study contribution. More articles by this author Liyan Ao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China Chinese PLA Medical School, Beijing, China More articles by this author Haiyi Wang Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China More articles by this author Wei Chen Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China More articles by this author Baixuan Xu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China More articles by this author Alberto Olivero Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy More articles by this author Jiajin Liu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China More articles by this author Jiangping Gao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China More articles by this author Yu Gao Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China More articles by this author Weijun Fu Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China More articles by this author Xin Ma Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China More articles by this author Hongzhao Li Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China More articles by this author Baojun Wang Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China Equal study contribution. More articles by this author Yachao Liu Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China Equal study contribution. More articles by this author Xu Zhang Corresponding Author: Xu Zhang, PhD, Department of Urology, the Third Medical Centre, Chinese PLA General Hospital, 69 Yong Ding Rd, Beijing, 100039, China ([email protected]) Equal study contribution. More articles by this author Expand All Funding/Support: This project was supported by the Outstanding Youth Training Program and the Project of Construction of Precision Diagnosis and Treatment Technology System for Prostate Cancer in Elderly Population (21BJZ27) of PLA General Hospital. The sponsor played a role in the design and conduct of the study, data collection, and preparation of the manuscript. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. S2021-565-01). All human subjects provided written informed consent with guarantees of confidentiality. Author contributions: Conception and design: Zhang, Niu, Ao, Xu, Olivero, J. Gao, Fu, Ma, Li, B. Wang, Y. Liu. Data analysis and interpretation: Niu, B. Liu, Ao, H. Wang, Fu, Y. Liu. Data acquisition: Niu, Ding, B. Liu, Ao, Chen, J. Liu, Y. Gao, Fu, Drafting the manuscript: Zhang, Niu, Ding, B. Liu, Ao, Y. Liu, B. Wang; Y. Liu. Critical revision of the manuscript for scientific and factual content: Ao, H. Wang, Chen, Xu, Olivero, J. Liu, J. Gao, Y. Gao, Fu, Ma, Li, Y. Liu. Statistical analysis: Niu, Ding, B. Liu, Ao. Supervision: Zhang, Ao, H. Wang, Xu, Olivero, J. Liu, J. Gao, Fu, Ma, Li, B. Wang, Y. Liu. Advertisement PDF downloadLoading ...