Evidence map›Paper›PMID 35330410›Full record

ArticleJournal of personalized medicine2022

Very Low Prostate PET/CT PSMA Uptake May Be Misleading in Staging Radical Prostatectomy Candidates.

Barak Rosenzweig, Rennen Haramaty, Tima Davidson, Alon Lazarovich, Asaf Shvero, Miki Haifler, Jonathan Gal, Shay Golan, Sagi Shpitzer, Azik Hoffman and 4 more

Abstract read
In one paragraph

Article in Journal of personalized medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Barak RosenzweigDepartment of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel.
Rennen HaramatyDepartment of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel.
Tima DavidsonSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Alon LazarovichDepartment of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel.
Asaf ShveroDepartment of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel.
Miki HaiflerSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Jonathan GalDepartment of Urology, Shamir Medical Center, Tzrifin 6093000, Israel.ORCID 0000-0001-5084-3215
Shay GolanSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.ORCID 0000-0002-9205-5820
Sagi ShpitzerSection of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel.
Azik HoffmanDepartment of Urology, Rambam Health Center, Haifa 3109601, Israel.
Omri NativDepartment of Urology, Rambam Health Center, Haifa 3109601, Israel.
Yuval FreifeldRuth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel.
Rani ZreikRuth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel.
Zohar A DotanDepartment of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel.ORCID 0000-0002-9005-2992

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: to evaluate a unique subpopulation of radical prostatectomy (RP) candidates with “negative” prostate 68Ga-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT) imaging scans and to characterize the clinical implications of misleading findings. Materials and Methods: This case-control retrospective study compared the final histological outcomes of patients with “negative” pre-RP PSMA PET/CT prostate scans (with a prostate maximal standardized uptake value [SUVmax] below the physiologic uptake) to those with an “intense” prostatic tracer uptake (with a SUVmax above the physiologic uptake). The patients underwent an RP between March 2015 and July 2019 in five academic centers. Data on the demographics, comorbidities, prostate-specific antigen (PSA) and rectal exam findings, prior biopsies, imaging results, biopsies, and RP histology results were collected. Results: Ninety-seven of the 392 patients who underwent an RP had PSMA PET/CT imaging preoperatively. Fifty-two (54%) had a “negative” uptake (in the study group), and 45 (46%) had a “positive” uptake (in the control group). Only the lesion size and SUVmax values on the PSMA PET/CT differed between the groups preoperatively. On the histological analysis, only the ISUP score, seminal vesicles invasion, T stage, and positive margin rates differed between the groups (p < 0.05), while 50 (96%) study group patients harbored clinically significant disease (ISUP ≥ 2), with an extra-prostatic disease in 24 (46%), perineural invasion in 35 (67%), and positive lymph nodes in 4 (8%). Conclusions: Disease aggressiveness generally correlated with an intense PSMA uptake on the preoperative PSMA PET/CT, but a subpopulation of patients with clinically significant cancer and aggressive characteristics showed a deceptively weak PSMA uptake. These data raise a concern about the unqualified application of PSMA PET/CT for staging RP candidates.

Indexed as

imagingprostate cancerprostate-specific membrane antigen (PSMA)radical prostatectomystaging

Identifiers

PMID35330410
PMCPMC8951096

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