[18F]-Fluciclovine PET/CT for preoperative nodal staging in high-risk primary prostate cancer: final results of a prospective trial
Purpose The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection (PLND) represents the only reliable method, although invasive. A new amino acid PET compound, [ 18 F]-fluciclovine, was recently auth...
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| Vydané v: | European journal of nuclear medicine and molecular imaging Ročník 49; číslo 1; s. 390 - 409 |
|---|---|
| Hlavní autori: | , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.12.2021
Springer Nature B.V |
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| ISSN: | 1619-7070, 1619-7089 |
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| Abstract | Purpose
The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection (PLND) represents the only reliable method, although invasive. A new amino acid PET compound, [
18
F]-fluciclovine, was recently authorized in suspected PCa recurrence but not yet included in the standard staging work-up of primary PCa. A prospective monocentric study was designed to evaluate [
18
F]-fluciclovine PET/CT diagnostic performance for preoperative LN staging in primary high-risk PCa.
Methods
Consecutive patients (pts) with biopsy-proven PCa, standard staging (including [
11
C]choline PET/CT), eligible for PLND, were enrolled to undergo an investigational [
18
F]-fluciclovine PET/CT. Nodal uptake higher than surrounding background was reported by at least two readers (blinded to [
11
C]choline) using a visual 5-point scale (1–2 probably negative; 4–5 probably positive; 3 equivocal); SUVmax, target-to-background (aorta—A; bone marrow—BM) ratios (TBRs), were also calculated. PET results were validated with PLND. [
18
F]-fluciclovine PET/CT performance using visual score and semi-quantitative indexes was analyzed both per patient and per LN anatomical region, compared to conventional [
11
C]choline and clinical predictive factors (to note that diagnostic performance of [
18
F]-fluciclovine was explored for LNM but not examined for intrapelvic or extrapelvic M1 lesions).
Results
Overall, 94 pts underwent [
18
F]-fluciclovine PET/CT; 72/94 (77%) high-risk pts were included in the final analyses (22 pts excluded: 8 limited PLND; 3 intermediate-risk; 2 treated with radiotherapy; 4 found to be M1; 5 neoadjuvant hormonal therapy). Median LNM risk by Briganti nomogram was 19%. LNM confirmed on histology was 25% (18/72 pts). Overall, 1671 LN were retrieved; 45/1671 (3%) LNM detected. Per pt, median no. of removed LN was 22 (mean 23 ± 10; range 8–51), of LNM was 2 (mean 3 ± 2; range 1–10). Median LNM size was 5 mm (mean 5 ± 2.5; range 2–10). On patient-based analyses (n = 72), diagnostic performance for LNM resulted significant with [
18
F]-fluciclovine (AUC 0.66,
p
0.04; 50% sensitivity, 81% specificity, 47% PPV, 83% NPV, 74% accuracy), but not with [
11
C]choline (AUC 0.60,
p
0.2; 50%, 70%, 36%, 81%, and 65% respectively). Briganti nomogram (OR = 1.03,
p
= 0.04) and [
18
F]-fluciclovine visual score (≥ 4) (OR = 4.27,
p
= 0.02) resulted independent predictors of LNM at multivariable analyses. On region-based semi-quantitative analyses (n = 576), PET/CT performed better using TBR parameters (TBR-A similar to TBR-BM; TBR-A fluciclovine AUC 0.61,
p
0.35, vs choline AUC 0.57
p
0.54; TBR-BM fluciclovine AUC 0.61,
p
0.36, vs choline AUC 0.58,
p
0.52) rather than using absolute LN SUVmax (fluciclovine AUC 0.51,
p
0.91, vs choline AUC 0.51,
p
0.94). However, in all cases, diagnostic performance was not statistically significant for LNM detection, although slightly in favor of the experimental tracer [
18
F]-fluciclovine for each parameter. On the contrary, visual interpretation significantly outperformed PET semi-quantitative parameters (choline and fluciclovine: AUC 0.65 and 0.64 respectively;
p
0.03) and represents an independent predictive factor of LNM with both tracers, in particular [
18
F]-fluciclovine (OR = 8.70,
p
0.002, vs OR = 3.98,
p
= 0.03).
Conclusion
In high-risk primary PCa, [
18
F]-fluciclovine demonstrates some advantages compared with [
11
C]choline but sensitivity for metastatic LN detection is still inadequate compared to PLND. Visual (combined morphological and functional), compared to semi-quantitative assessment, is promising but relies mainly on readers’ experience rather than on unquestionable LN avidity.
Trial registration
EudraCT number: 2014–003,165-15 |
|---|---|
| AbstractList | PurposeThe conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection (PLND) represents the only reliable method, although invasive. A new amino acid PET compound, [18F]-fluciclovine, was recently authorized in suspected PCa recurrence but not yet included in the standard staging work-up of primary PCa. A prospective monocentric study was designed to evaluate [18F]-fluciclovine PET/CT diagnostic performance for preoperative LN staging in primary high-risk PCa.MethodsConsecutive patients (pts) with biopsy-proven PCa, standard staging (including [11C]choline PET/CT), eligible for PLND, were enrolled to undergo an investigational [18F]-fluciclovine PET/CT. Nodal uptake higher than surrounding background was reported by at least two readers (blinded to [11C]choline) using a visual 5-point scale (1–2 probably negative; 4–5 probably positive; 3 equivocal); SUVmax, target-to-background (aorta—A; bone marrow—BM) ratios (TBRs), were also calculated. PET results were validated with PLND. [18F]-fluciclovine PET/CT performance using visual score and semi-quantitative indexes was analyzed both per patient and per LN anatomical region, compared to conventional [11C]choline and clinical predictive factors (to note that diagnostic performance of [18F]-fluciclovine was explored for LNM but not examined for intrapelvic or extrapelvic M1 lesions).ResultsOverall, 94 pts underwent [18F]-fluciclovine PET/CT; 72/94 (77%) high-risk pts were included in the final analyses (22 pts excluded: 8 limited PLND; 3 intermediate-risk; 2 treated with radiotherapy; 4 found to be M1; 5 neoadjuvant hormonal therapy). Median LNM risk by Briganti nomogram was 19%. LNM confirmed on histology was 25% (18/72 pts). Overall, 1671 LN were retrieved; 45/1671 (3%) LNM detected. Per pt, median no. of removed LN was 22 (mean 23 ± 10; range 8–51), of LNM was 2 (mean 3 ± 2; range 1–10). Median LNM size was 5 mm (mean 5 ± 2.5; range 2–10). On patient-based analyses (n = 72), diagnostic performance for LNM resulted significant with [18F]-fluciclovine (AUC 0.66, p 0.04; 50% sensitivity, 81% specificity, 47% PPV, 83% NPV, 74% accuracy), but not with [11C]choline (AUC 0.60, p 0.2; 50%, 70%, 36%, 81%, and 65% respectively). Briganti nomogram (OR = 1.03, p = 0.04) and [18F]-fluciclovine visual score (≥ 4) (OR = 4.27, p = 0.02) resulted independent predictors of LNM at multivariable analyses. On region-based semi-quantitative analyses (n = 576), PET/CT performed better using TBR parameters (TBR-A similar to TBR-BM; TBR-A fluciclovine AUC 0.61, p 0.35, vs choline AUC 0.57 p 0.54; TBR-BM fluciclovine AUC 0.61, p 0.36, vs choline AUC 0.58, p 0.52) rather than using absolute LN SUVmax (fluciclovine AUC 0.51, p 0.91, vs choline AUC 0.51, p 0.94). However, in all cases, diagnostic performance was not statistically significant for LNM detection, although slightly in favor of the experimental tracer [18F]-fluciclovine for each parameter. On the contrary, visual interpretation significantly outperformed PET semi-quantitative parameters (choline and fluciclovine: AUC 0.65 and 0.64 respectively; p 0.03) and represents an independent predictive factor of LNM with both tracers, in particular [18F]-fluciclovine (OR = 8.70, p 0.002, vs OR = 3.98, p = 0.03).ConclusionIn high-risk primary PCa, [18F]-fluciclovine demonstrates some advantages compared with [11C]choline but sensitivity for metastatic LN detection is still inadequate compared to PLND. Visual (combined morphological and functional), compared to semi-quantitative assessment, is promising but relies mainly on readers’ experience rather than on unquestionable LN avidity.Trial registrationEudraCT number: 2014–003,165-15 The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection (PLND) represents the only reliable method, although invasive. A new amino acid PET compound, [ F]-fluciclovine, was recently authorized in suspected PCa recurrence but not yet included in the standard staging work-up of primary PCa. A prospective monocentric study was designed to evaluate [ F]-fluciclovine PET/CT diagnostic performance for preoperative LN staging in primary high-risk PCa. Consecutive patients (pts) with biopsy-proven PCa, standard staging (including [ C]choline PET/CT), eligible for PLND, were enrolled to undergo an investigational [ F]-fluciclovine PET/CT. Nodal uptake higher than surrounding background was reported by at least two readers (blinded to [ C]choline) using a visual 5-point scale (1-2 probably negative; 4-5 probably positive; 3 equivocal); SUVmax, target-to-background (aorta-A; bone marrow-BM) ratios (TBRs), were also calculated. PET results were validated with PLND. [ F]-fluciclovine PET/CT performance using visual score and semi-quantitative indexes was analyzed both per patient and per LN anatomical region, compared to conventional [ C]choline and clinical predictive factors (to note that diagnostic performance of [ F]-fluciclovine was explored for LNM but not examined for intrapelvic or extrapelvic M1 lesions). Overall, 94 pts underwent [ F]-fluciclovine PET/CT; 72/94 (77%) high-risk pts were included in the final analyses (22 pts excluded: 8 limited PLND; 3 intermediate-risk; 2 treated with radiotherapy; 4 found to be M1; 5 neoadjuvant hormonal therapy). Median LNM risk by Briganti nomogram was 19%. LNM confirmed on histology was 25% (18/72 pts). Overall, 1671 LN were retrieved; 45/1671 (3%) LNM detected. Per pt, median no. of removed LN was 22 (mean 23 ± 10; range 8-51), of LNM was 2 (mean 3 ± 2; range 1-10). Median LNM size was 5 mm (mean 5 ± 2.5; range 2-10). On patient-based analyses (n = 72), diagnostic performance for LNM resulted significant with [ F]-fluciclovine (AUC 0.66, p 0.04; 50% sensitivity, 81% specificity, 47% PPV, 83% NPV, 74% accuracy), but not with [ C]choline (AUC 0.60, p 0.2; 50%, 70%, 36%, 81%, and 65% respectively). Briganti nomogram (OR = 1.03, p = 0.04) and [ F]-fluciclovine visual score (≥ 4) (OR = 4.27, p = 0.02) resulted independent predictors of LNM at multivariable analyses. On region-based semi-quantitative analyses (n = 576), PET/CT performed better using TBR parameters (TBR-A similar to TBR-BM; TBR-A fluciclovine AUC 0.61, p 0.35, vs choline AUC 0.57 p 0.54; TBR-BM fluciclovine AUC 0.61, p 0.36, vs choline AUC 0.58, p 0.52) rather than using absolute LN SUVmax (fluciclovine AUC 0.51, p 0.91, vs choline AUC 0.51, p 0.94). However, in all cases, diagnostic performance was not statistically significant for LNM detection, although slightly in favor of the experimental tracer [ F]-fluciclovine for each parameter. On the contrary, visual interpretation significantly outperformed PET semi-quantitative parameters (choline and fluciclovine: AUC 0.65 and 0.64 respectively; p 0.03) and represents an independent predictive factor of LNM with both tracers, in particular [ F]-fluciclovine (OR = 8.70, p 0.002, vs OR = 3.98, p = 0.03). In high-risk primary PCa, [ F]-fluciclovine demonstrates some advantages compared with [ C]choline but sensitivity for metastatic LN detection is still inadequate compared to PLND. Visual (combined morphological and functional), compared to semi-quantitative assessment, is promising but relies mainly on readers' experience rather than on unquestionable LN avidity. EudraCT number: 2014-003,165-15. Purpose The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection (PLND) represents the only reliable method, although invasive. A new amino acid PET compound, [ 18 F]-fluciclovine, was recently authorized in suspected PCa recurrence but not yet included in the standard staging work-up of primary PCa. A prospective monocentric study was designed to evaluate [ 18 F]-fluciclovine PET/CT diagnostic performance for preoperative LN staging in primary high-risk PCa. Methods Consecutive patients (pts) with biopsy-proven PCa, standard staging (including [ 11 C]choline PET/CT), eligible for PLND, were enrolled to undergo an investigational [ 18 F]-fluciclovine PET/CT. Nodal uptake higher than surrounding background was reported by at least two readers (blinded to [ 11 C]choline) using a visual 5-point scale (1–2 probably negative; 4–5 probably positive; 3 equivocal); SUVmax, target-to-background (aorta—A; bone marrow—BM) ratios (TBRs), were also calculated. PET results were validated with PLND. [ 18 F]-fluciclovine PET/CT performance using visual score and semi-quantitative indexes was analyzed both per patient and per LN anatomical region, compared to conventional [ 11 C]choline and clinical predictive factors (to note that diagnostic performance of [ 18 F]-fluciclovine was explored for LNM but not examined for intrapelvic or extrapelvic M1 lesions). Results Overall, 94 pts underwent [ 18 F]-fluciclovine PET/CT; 72/94 (77%) high-risk pts were included in the final analyses (22 pts excluded: 8 limited PLND; 3 intermediate-risk; 2 treated with radiotherapy; 4 found to be M1; 5 neoadjuvant hormonal therapy). Median LNM risk by Briganti nomogram was 19%. LNM confirmed on histology was 25% (18/72 pts). Overall, 1671 LN were retrieved; 45/1671 (3%) LNM detected. Per pt, median no. of removed LN was 22 (mean 23 ± 10; range 8–51), of LNM was 2 (mean 3 ± 2; range 1–10). Median LNM size was 5 mm (mean 5 ± 2.5; range 2–10). On patient-based analyses (n = 72), diagnostic performance for LNM resulted significant with [ 18 F]-fluciclovine (AUC 0.66, p 0.04; 50% sensitivity, 81% specificity, 47% PPV, 83% NPV, 74% accuracy), but not with [ 11 C]choline (AUC 0.60, p 0.2; 50%, 70%, 36%, 81%, and 65% respectively). Briganti nomogram (OR = 1.03, p = 0.04) and [ 18 F]-fluciclovine visual score (≥ 4) (OR = 4.27, p = 0.02) resulted independent predictors of LNM at multivariable analyses. On region-based semi-quantitative analyses (n = 576), PET/CT performed better using TBR parameters (TBR-A similar to TBR-BM; TBR-A fluciclovine AUC 0.61, p 0.35, vs choline AUC 0.57 p 0.54; TBR-BM fluciclovine AUC 0.61, p 0.36, vs choline AUC 0.58, p 0.52) rather than using absolute LN SUVmax (fluciclovine AUC 0.51, p 0.91, vs choline AUC 0.51, p 0.94). However, in all cases, diagnostic performance was not statistically significant for LNM detection, although slightly in favor of the experimental tracer [ 18 F]-fluciclovine for each parameter. On the contrary, visual interpretation significantly outperformed PET semi-quantitative parameters (choline and fluciclovine: AUC 0.65 and 0.64 respectively; p 0.03) and represents an independent predictive factor of LNM with both tracers, in particular [ 18 F]-fluciclovine (OR = 8.70, p 0.002, vs OR = 3.98, p = 0.03). Conclusion In high-risk primary PCa, [ 18 F]-fluciclovine demonstrates some advantages compared with [ 11 C]choline but sensitivity for metastatic LN detection is still inadequate compared to PLND. Visual (combined morphological and functional), compared to semi-quantitative assessment, is promising but relies mainly on readers’ experience rather than on unquestionable LN avidity. Trial registration EudraCT number: 2014–003,165-15 |
| Author | Porreca, Angelo Bianchi, Lorenzo Giunchi, Francesca Nanni, Cristina Zanoni, Lucia Brunocilla, Eugenio Bossert, Irene Matti, Antonella Fonti, Cristina D’Errico, Antonietta Fanti, Stefano Pultrone, Cristian Lodi, Filippo Schiavina, Riccardo Romagnoli, Daniele Fiorentino, Michelangelo |
| Author_xml | – sequence: 1 givenname: Lucia orcidid: 0000-0002-6784-8220 surname: Zanoni fullname: Zanoni, Lucia email: lucia.zanoni@aosp.bo.it organization: Nuclear Medicine, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 2 givenname: Lorenzo surname: Bianchi fullname: Bianchi, Lorenzo organization: Division of Urology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna – sequence: 3 givenname: Cristina surname: Nanni fullname: Nanni, Cristina organization: Nuclear Medicine, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 4 givenname: Cristian surname: Pultrone fullname: Pultrone, Cristian organization: Division of Urology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 5 givenname: Francesca surname: Giunchi fullname: Giunchi, Francesca organization: Pathology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 6 givenname: Irene surname: Bossert fullname: Bossert, Irene organization: Nuclear Medicine, Istituti Clinici Scientifici Maugeri – sequence: 7 givenname: Antonella surname: Matti fullname: Matti, Antonella organization: Nuclear Medicine, IRCCS Ospedale Sacro Cuore - Don Calabria – sequence: 8 givenname: Riccardo surname: Schiavina fullname: Schiavina, Riccardo organization: Division of Urology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna – sequence: 9 givenname: Michelangelo surname: Fiorentino fullname: Fiorentino, Michelangelo organization: Department of Specialistic Diagnostic and Experimental Medicine, University of Bologna – sequence: 10 givenname: Daniele surname: Romagnoli fullname: Romagnoli, Daniele organization: Urology Unit, Abano Terme Hospital – sequence: 11 givenname: Cristina surname: Fonti fullname: Fonti, Cristina organization: Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Istituto Delle Scienze Neurologiche Di Bologna – sequence: 12 givenname: Filippo surname: Lodi fullname: Lodi, Filippo organization: Nuclear Medicine, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 13 givenname: Antonietta surname: D’Errico fullname: D’Errico, Antonietta organization: Pathology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna – sequence: 14 givenname: Eugenio surname: Brunocilla fullname: Brunocilla, Eugenio organization: Division of Urology, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna – sequence: 15 givenname: Angelo surname: Porreca fullname: Porreca, Angelo organization: Oncological Urology, Veneto Institute of Oncology IOV - IRCCS – sequence: 16 givenname: Stefano surname: Fanti fullname: Fanti, Stefano organization: Nuclear Medicine, Istituto Di Ricovero E Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria Di Bologna, DIMES, University of Bologna |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34213609$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_diagnostics14131315 crossref_primary_10_1053_j_semnuclmed_2023_06_004 crossref_primary_10_3390_cancers15194746 crossref_primary_10_1016_j_mednuc_2023_07_008 crossref_primary_10_1016_j_cpet_2022_07_005 crossref_primary_10_2147_IJGM_S351265 crossref_primary_10_1097_CCO_0000000000000932 crossref_primary_10_3390_cancers16142531 |
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| ContentType | Journal Article |
| Copyright | The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021. |
| Copyright_xml | – notice: The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 – notice: 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. – notice: The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021. |
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| DOI | 10.1007/s00259-021-05429-6 |
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| Issue | 1 |
| Keywords | High risk F]-Fluciclovine PET/CT Lymph node staging [ Prostate cancer [18F]-Fluciclovine PET/CT |
| Language | English |
| License | 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
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| PublicationTitle | European journal of nuclear medicine and molecular imaging |
| PublicationTitleAbbrev | Eur J Nucl Med Mol Imaging |
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Available from: https://www.edqm.eu/en/european-pharmacopoeia-ph-eur-10th-e R Schiavina (5429_CR4) 2018; 32 DM Schuster (5429_CR67) 2014; 55 F Ceci (5429_CR13) 2020; 47 S Ganeshalingam (5429_CR6) 2009; 9 L Budäus (5429_CR66) 2016; 69 5429_CR5 L Bianchi (5429_CR14) 2019; 26 M Kanagawa (5429_CR34) 2014; 41 5429_CR1 5429_CR2 R Schiavina (5429_CR55) 2015; 13 5429_CR28 5429_CR29 5429_CR26 5429_CR27 D Gabriele (5429_CR47) 2016; 34 5429_CR8 5429_CR24 I Jambor (5429_CR40) 2018; 45 5429_CR68 DM Schuster (5429_CR17) 2007; 48 DM Schuster (5429_CR21) 2013; 3 5429_CR25 5429_CR22 5429_CR23 5429_CR20 A Herlemann (5429_CR58) 2016; 70 5429_CR63 5429_CR61 KM Selnæs (5429_CR39) 2018; 28 MG Harisinghani (5429_CR45) 2003; 348 L Bianchi (5429_CR32) 2020; 72 C Testa (5429_CR3) 2010; 23 L Spevack (5429_CR50) 1996; 34 R Schiavina (5429_CR52) 2008; 54 AM McDonald (5429_CR54) 2019; 4 S Hijazi (5429_CR59) 2015; 75 5429_CR18 MP Miller (5429_CR53) 2017; 58 5429_CR15 R Schiavina (5429_CR9) 2018; 16 S Tulsyan (5429_CR64) 2017; 38 5429_CR12 5429_CR10 F Ceci (5429_CR7) 2013; 40 R Tiguert (5429_CR49) 1999; 53 5429_CR51 LWM van Kalmthout (5429_CR62) 2020; 203 SJ Kim (5429_CR36) 2019; 74 T Pyka (5429_CR60) 2016; 43 M Alemozaffar (5429_CR38) 2020; 204 H Suzuki (5429_CR35) 2019; 49 C Uprimny (5429_CR65) 2017; 44 5429_CR44 5429_CR42 5429_CR43 5429_CR41 D Weckermann (5429_CR11) 2007; 51 A Briganti (5429_CR16) 2012; 61 P Borrelli (5429_CR56) 2021; 41 AM Hövels (5429_CR46) 2008; 63 T Maurer (5429_CR57) 2016; 195 RC Flanigan (5429_CR48) 1996; 48 5429_CR37 JA Nye (5429_CR19) 2007; 48 5429_CR33 5429_CR31 5429_CR30 |
| References_xml | – reference: Farolfi A Ceci F Castellucci P Graziani T Siepe G Lambertini A et al 68Ga-PSMA-11 PET/CT in prostate cancer patients with biochemical recurrence after radical prostatectomy and PSA <0.5 ng/ml Efficacy and impact on treatment strategy Eur J Nucl Med Mol Imaging Springer Berlin Heidelberg 2019 4611 9 – reference: Giesel FL, Sterzing F, Schlemmer HP, Holland-Letz T, Mier & W, Rius & M, et al. Intra-individual comparison of 68 Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43(8):1400–6. – reference: SchiavinaRScattoniVCastellucciPPicchioMCortiBBrigantiA11C-Choline positron emission tomography/computerized tomography for preoperative lymph-node staging in intermediate-risk and high-risk prostate cancer: comparison with clinical staging nomogramsEur Urol Eur Urol20085439240110.1016/j.eururo.2008.04.030 – reference: TiguertRGheilerELTefilliMVOskanianPBanerjeeMGrignonDJLymph node size does not correlate with the presence of prostate cancer metastasisUrology Urology19995336737110.1016/S0090-4295(98)00518-41:STN:280:DyaK1M7ivFygtA%3D%3D – reference: Fendler WP, Eiber M, Beheshti M, Bomanji J, Ceci F, Cho S, et al. 68Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging. 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Available from: https://www.aimn.it/site/page/attivita/linee-guida – reference: van KalmthoutLWMvan MelickHHELavalayeJMeijerRPKooistraAde KlerkJMHProspective validation of gallium-68 prostate specific membrane antigen-positron emission tomography/computerized tomography for primary staging of prostate cancerJ Urol NLM (Medline)202020353754510.1097/JU.0000000000000531 – reference: Galgano SJ, Mcdonald A, Rais-Bahrami S, Porter KK, Choudhary G, Burgan C, et al. Utility of 18F-fluciclovine PET/MRI for staging newly diagnosed high-risk prostate cancer and evaluating response to initial androgen deprivation therapy: a prospective single-arm pilot study.AJR Am J Roentgenol. 2020 Oct 14. – reference: BrigantiALarcherAAbdollahFCapitanioUGallinaASuardiNUpdated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive coresEur Urol Eur Urol20126148048710.1016/j.eururo.2011.10.044 – reference: HarisinghaniMGBarentszJHahnPFDesernoWMTabatabaeiSvan de KaaCHNoninvasive detection of clinically occult lymph-node metastases in prostate cancerN Engl J Med. New England Journal of Medicine (NEJM/MMS)20033482491910.1056/NEJMoa022749 – reference: BianchiLSchiavinaRBorghesiMCeciFAngioliniAChessaFHow does 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery?Int J Urol Blackwell Publishing20192680481110.1111/iju.14012 – reference: FlaniganRCMcKayTCOlsonMShankeyTVPyleJWatersWBLimited efficacy of preoperative computed tomographic scanning for the evaluation of lymph node metastasis in patients before radical prostatectomy. UrologyElsevier Inc.199648428321:STN:280:DyaK28zpslKjsQ%3D%3D – reference: MillerMPKostakogluLPrymaDYuJQChauAPerlmanEReader training for the restaging of biochemically recurrent prostate cancer using 18F-fluciclovine PET/CTJ Nucl Med. 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The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node... The conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node dissection... PurposeThe conventional imaging flowchart for prostate cancer (PCa) staging may fail in correctly detecting lymph node metastases (LNM). Pelvic lymph node... |
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