Predictive value of the 68Ga-PSMA-11 PET/CT PRIMARY score for pathological upgrading in patients with ISUP Grade 1 prostate cancer and PSA < 20 ng/mL undergoing radical prostatectomy - PubMed
4 hours ago
- #PSMA PET/CT
- #Pathological Upgrading
- #Prostate Cancer
- The study evaluates the 68Ga-PSMA-11 PET/CT PRIMARY score's ability to predict pathological upgrading in ISUP Grade Group 1 prostate cancer patients with PSA < 20 ng/mL undergoing radical prostatectomy.
- Pathological upgrading was observed in 63.4% of patients, with higher PRIMARY scores (≥4) strongly correlating with increased upgrading rates (81.3% for score 4, 100% for score 5).
- The PRIMARY score ≥4 demonstrated excellent diagnostic performance (AUC = 0.979), with high sensitivity (97.8%), specificity (88.5%), and accuracy (94.3%).
- Multivariate analysis confirmed the PRIMARY score as an independent predictor of upgrading (OR: 19.9; 95% CI: 2.92-135.28; p = 0.002), outperforming SUVmax and PI-RADS scores.
- The findings suggest that PSMA-based intraprostatic pattern analysis could enhance preoperative grading accuracy, aiding in treatment strategy decisions, though prospective multicenter validation is needed.