Evidence map›Paper›PMID 39075567›Full record

ArticleCancer imaging : the official publication of the International Cancer Imaging Society2024

Pelvic lymph node mapping in prostate cancer: examining the impact of PSMA PET/CT on radiotherapy decision-making in patients with node-positive disease.

Ben Furman, Tal Falick Michaeli, Robert Den, Simona Ben Haim, Aron Popovtzer, Marc Wygoda, Philip Blumenfeld

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Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
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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

7 authors.

Ben FurmanDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel.
Tal Falick MichaeliDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel.
Robert DenDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel.
Simona Ben HaimDepartment of Nuclear Medicine and Medical Biophysics, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel.
Aron PopovtzerDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel.
Marc WygodaDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel.
Philip BlumenfeldDepartment of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12272, Jerusalem, 9112002, Israel. philipb@hadassah.org.il.ORCID https://orcid.org/0000-0003-4672-6862

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionProstate Specific Membrane Antigen (PSMA) imaging with Positron Emission Tomography (PET) plays a crucial role in prostate cancer management. However, there is a lack of comprehensive data on how PSMA PET/CT (Computed Tomography) influences radiotherapeutic decisions, particularly in node-positive prostate cancer cases. This study aims to address this gap by evaluating two primary objectives: (1) Mapping the regional and non-regional lymph nodes (LNs) up to the aortic bifurcation and their distribution using conventional methods with CT compared to PSMA PET/CT, and (2) assessing the impact of PSMA PET/CT findings on radiotherapeutic decisions.

methodsA retrospective analysis of 95 node-positive prostate cancer patients who underwent both CT and PSMA PET/CT imaging prior to primary radiotherapy and androgen deprivation therapy (ADT) was conducted. The analysis focused on identifying LNs in various regions including the common iliac, external iliac, internal iliac, obturator, presacral, mesorectal, inguinal, and other stations. Treatment plans were reviewed for modifications based on PSMA PET/CT findings, and statistical analysis was performed to identify predictors for exclusive nodal positivity on PSMA PET/CT scans.

resultsPSMA PET/CT identified additional positive nodes in 48% of cases, resulting in a staging shift from N0 to N1 in 29% of patients. The most frequent metastatic LNs were located in the external iliac (76 LNs; 34%), internal iliac (43 LNs; 19%), and common iliac (35 LNs; 15%) stations. In patients with nodes only detected on PSMA PET the most common nodes were in the external iliac (27, 40%), internal iliac (13, 19%), obturator (11, 15%) stations. Within the subgroup of 28 patients exclusively demonstrating PSMA PET-detected nodes, changes in radiotherapy treatment fields were implemented in 5 cases (18%), and a dose boost was applied for 23 patients (83%). However, no discernible predictors for exclusive nodal positivity on PSMA PET/CT scans emerged from the analysis. DISCUSSION: The study underscores the pivotal role of PSMA PET/CT compared to CT alone in accurately staging node-positive prostate cancer and guiding personalized radiotherapy strategies. The routine integration of PSMA PET/CT into diagnostic protocols is advocated to optimize treatment precision and improve patient outcomes.

Indexed as

Antigens, SurfaceLymphatic MetastasisLymph NodesPositron Emission Tomography Computed TomographyProstatic NeoplasmsAgedAged, 80 and overClinical Decision-MakingGlutamate Carboxypeptidase IIHumansMaleMiddle AgedPelvisRadiotherapy Planning, Computer-AssistedRetrospective StudiesAntigens, SurfaceFOLH1 protein, humanGlutamate Carboxypeptidase II

Identifiers

PMID39075567
PMCPMC11285572

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.