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Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer

Over the last years, prostate magnetic resonance imaging (MRI) has gained a key role in the primary diagnosis of clinically significant prostate cancer (csPCa). While a negative MRI can avoid unnecessary prostate biopsies and the overdiagnosis of indolent cancers, a positive examination triggers bio...

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Autores principales: Cereser, Lorenzo, Evangelista, Laura, Giannarini, Gianluca, Girometti, Rossano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453091/
https://www.ncbi.nlm.nih.gov/pubmed/37627956
http://dx.doi.org/10.3390/diagnostics13162697
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author Cereser, Lorenzo
Evangelista, Laura
Giannarini, Gianluca
Girometti, Rossano
author_facet Cereser, Lorenzo
Evangelista, Laura
Giannarini, Gianluca
Girometti, Rossano
author_sort Cereser, Lorenzo
collection PubMed
description Over the last years, prostate magnetic resonance imaging (MRI) has gained a key role in the primary diagnosis of clinically significant prostate cancer (csPCa). While a negative MRI can avoid unnecessary prostate biopsies and the overdiagnosis of indolent cancers, a positive examination triggers biopsy samples targeted to suspicious imaging findings, thus increasing the diagnosis of csPCa with a sensitivity and negative predictive value of around 90%. The limitations of MRI, including suboptimal positive predictive values, are fueling debate on how to stratify biopsy decisions and management based on patient risk and how to correctly estimate it with clinical and/or imaging findings. In this setting, “next-generation imaging” imaging based on radiolabeled Prostate-Specific Membrane Antigen (PSMA)-Positron Emission Tomography (PET) is expanding its indications both in the setting of primary staging (intermediate-to-high risk patients) and primary diagnosis (e.g., increasing the sensitivity of MRI or acting as a problem-solving tool for indeterminate MRI cases). This review summarizes the current main evidence on the role of prostate MRI and PSMA-PET as tools for the primary diagnosis of csPCa, and the different possible interaction pathways in this setting.
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spelling pubmed-104530912023-08-26 Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer Cereser, Lorenzo Evangelista, Laura Giannarini, Gianluca Girometti, Rossano Diagnostics (Basel) Review Over the last years, prostate magnetic resonance imaging (MRI) has gained a key role in the primary diagnosis of clinically significant prostate cancer (csPCa). While a negative MRI can avoid unnecessary prostate biopsies and the overdiagnosis of indolent cancers, a positive examination triggers biopsy samples targeted to suspicious imaging findings, thus increasing the diagnosis of csPCa with a sensitivity and negative predictive value of around 90%. The limitations of MRI, including suboptimal positive predictive values, are fueling debate on how to stratify biopsy decisions and management based on patient risk and how to correctly estimate it with clinical and/or imaging findings. In this setting, “next-generation imaging” imaging based on radiolabeled Prostate-Specific Membrane Antigen (PSMA)-Positron Emission Tomography (PET) is expanding its indications both in the setting of primary staging (intermediate-to-high risk patients) and primary diagnosis (e.g., increasing the sensitivity of MRI or acting as a problem-solving tool for indeterminate MRI cases). This review summarizes the current main evidence on the role of prostate MRI and PSMA-PET as tools for the primary diagnosis of csPCa, and the different possible interaction pathways in this setting. MDPI 2023-08-17 /pmc/articles/PMC10453091/ /pubmed/37627956 http://dx.doi.org/10.3390/diagnostics13162697 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Cereser, Lorenzo
Evangelista, Laura
Giannarini, Gianluca
Girometti, Rossano
Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title_full Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title_fullStr Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title_full_unstemmed Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title_short Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer
title_sort prostate mri and psma-pet in the primary diagnosis of prostate cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453091/
https://www.ncbi.nlm.nih.gov/pubmed/37627956
http://dx.doi.org/10.3390/diagnostics13162697
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