Please use this identifier to cite or link to this item: https://hdl.handle.net/1/2114
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dc.contributor.authorSheehan-Dare, Gemma-
dc.contributor.otherEmmett, L.M.-
dc.contributor.otherPapa, N.-
dc.contributor.otherButeau, J.-
dc.contributor.otherHo, B.-
dc.contributor.otherLiu, V.-
dc.contributor.otherRoberts, M.-
dc.contributor.otherThompson, J.-
dc.contributor.otherMoon, D.-
dc.contributor.otherAlghazo, O.-
dc.contributor.otherAgrawal, S.-
dc.contributor.otherMurphy, D.G.-
dc.contributor.otherStricker, P.-
dc.contributor.otherHope, T.A.-
dc.contributor.otherHofman, M.-
dc.date.accessioned2022-03-23T03:40:05Z-
dc.date.available2022-03-23T03:40:05Z-
dc.date.issued2022-03-
dc.identifier.citation63(11):1644-1650en
dc.identifier.issn0161-5505en
dc.identifier.urihttps://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/2114-
dc.description.abstractBackground: Multi-parametric magnetic resonance imaging (mpMRI) is validated for the diagnosis of clinically significant prostate cancer (csPCa). (68)Ga-PSMA -11 PET/CT (PSMA-PET/CT) combined with mpMRI has improved negative predictive value over mpMRI alone for csPCa. The aim of this post-hoc analysis of the PRIMARY study was to evaluate the clinical significance of patterns of intra-prostatic PSMA activity, proposing a 5- point PRIMARY score to optimise accuracy of PSMA-PET/CT for csPCa in a low prevalence population. Methods: The PRIMARY trial is a prospective multi-centre phase II imaging trial that enrolled biopsy-naïve men with suspected PCa, no prior biopsy, recent mpMRI (6 months) and planned for prostate biopsy. 291 men underwent mpMRI, PSMA-PET/CT and systematic +/- targeted biopsy. The mpMRI was read separately using PI-RADS (V2). PSMA-PET/CT (pelvic only) was acquired a minimum 60 minutes post injection. PSMA-PET/CT was centrally read for pattern (diffuse transition zone (TZ), symmetrical central zone (CZ), focal TZ or peripheral zone (PZ), and intensity (SUV(max)). In this post-hoc analysis, a 5-level PRIMARY score was assigned based on analysis of the central read: 1. No pattern, 2. Diffuse TZ or CZ (no focal), 3. Focal TZ, 4. Focal PZ or 5. SUV(max) ≥ 12. Two further readers independently assigned a PRIMARY score to 118 scans for inter-rater agreement. Associations between PRIMARY score and csPCa (ISUP≥2) were evaluated. Results: Of 291 men enrolled, 162 (56%) had csPCa. PRIMARY score-1 was present in 16% (47), score-2 in 19% (55), score-3 in 10% (29), score-4 in 40% (117) and score-5 in 15% (43). The proportion of patients with csPCa and PRIMARY score 1 to 5 was 8.5% (4/47), 27% (15/55), 38% (11/29), 76% (89/117) and 100% (43/43) respectively. Sensitivity, specificity, PPV and NPV for PRIMARY score 1,2 (low-risk patterns) vs PRIMARY score 3-5 (high-risk patterns) was 88%, 64%, 76% and 81%, compared to 83%, 53%, 69% and 72% for PI-RADS (2 vs 3-5) on mpMRI. The inter-rater agreements for PRIMARY score 1,2 vs. PRIMARY score 3-5 was 0.76 (CI: 0.64-0.88) and 0.64 (CI: 0.49-0.78). Conclusion: A PRIMARY score incorporating intra-prostatic pattern and intensity on PSMA-PET/CT shows potential with high diagnostic accuracy for csPCa. Further validation is warranted prior to implementation.en
dc.description.sponsorshipRadiation Oncologyen
dc.subjectCanceren
dc.subjectRadiologyen
dc.titleThe PRIMARY Score: Using intra-prostatic 68GA-PSMA PET/CT patterns to optimise prostate cancer diagnosisen
dc.typeJournal Articleen
dc.identifier.doi10.2967/jnumed.121.263448en
dc.description.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/35301240/en
dc.description.affiliatesCentral Coast Local Health Districten
dc.identifier.journaltitleJournal of Nuclear Medicineen
dc.type.studyortrialMulticentre Studiesen
dc.relation.orcidhttps://orcid.org/ 0000-0003-2092-7922en
dc.originaltypeTexten
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.cerifentitytypePublications-
Appears in Collections:Oncology / Cancer
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