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Mismatched Imaging Findings of Prostate Cancer Diagnosis: 68 Ga-PSMA PET/CT vs mpMRI
Lopci Egesta,Colombo Piergiuseppe,Lazzeri Massimo 대한핵의학회 2021 핵의학 분자영상 Vol.55 No.4
Multiparametric magnetic resonance imaging (mpMRI) is the modality of choice for initial diagnosis of prostate cancer (PCa), including biopsy-naïve patients. Nevertheless, clinicians must be aware of the possibility that up to one-fourth of clinically significant cancers might be missed by the modality. Acknowledgment of this occurrence and the increased availability of 68 Ga-PSMA PET/CT in clinical routine, open the door to new, fascinating, indications for this functional modality in the context of PCa detection. With the case herein illustrated, we report a paradigmatic example of mismatch findings between PET/CT and mpMRI better elucidating the potential indication.
Fabio Grizzi,Gianluigi Taverna,Piergiuseppe Colombo,Mauro Seveso,Guido Giusti,Silvia Proietti,Girolamo Fiorini,Giovanni Lughezzani,Paolo Casale,Nicolò Buffi,Massimo Lazzari,Giorgio Guazzoni 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6
Purpose: Prostate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkerswith improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexityin prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlationsbetween the results and selected clinical and pathological parameters of prostate carcinoma. Materials and Methods: A total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostatecancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsysampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-μm sections were treated with CD34 antibodiesand were digitized by using an image analysis system that automatically estimates the surface fractal dimension. Results: Our results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlationswere found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathologicalstage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence. Conclusions: The value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancertissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmarkof intermediate- and high-risk prostate cancer.