2. UroToday Home
  3. Recent Abstracts
  4. Urologic Oncology
  5. Prostate Cancer

Radical 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

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.

Shaoxi Niu 1, Xiaohui Ding 2, Baichuan Liu 3 4, Liyan Ao 1 4, Haiyi Wang 3, Wei Chen 2, Baixuan Xu 5, Alberto Olivero 6, Jiajin Liu 5, Jiangping Gao 1, Yu Gao 1, Weijun Fu 1, Xin Ma 1, Hongzhao Li 1, Baojun Wang 1, Yachao Liu 5, Xu Zhang 1

  1. Department of Urology, the Third Medical Centre, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China.
  2. Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  3. Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
  4. Chinese PLA Medical School, Beijing, China.
  5. Department of Nuclear Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.
  6. Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Source: Niu S, Ding X, Liu B et al. Radical 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 Trial. J Urol. 2024 Aug;212(2):280-289. doi: 10.1097/JU.0000000000004025.