68Ga-PSMA PET/CT better characterises localised prostate cancer after MRI and transperineal prostate biopsy: Is 68Ga-PSMA PET/CT guided biopsy the future?

Abstract Purpose Prostate-specific membrane antigen (PSMA)-targeted PET is increasingly used for staging prostate cancer (PCa) with high accuracy to detect significant PCa (sigPCa). [68 Ga]PSMA-11 PET/MRI-guided biopsy showed promising results but also persisting limitation of sampling error, due to impaired image fusion. We aimed to assess the possibility of intraoperative quantification of [18F]PSMA-1007 PET/CT uptake in core biopsies as an instant confirmation for accurate lesion sampling. Methods In this IRB-approved, prospective, proof-of-concept study, we included five consecutive patients with suspected PCa. All underwent [18F]PSMA-1007 PET/CT scans followed by immediate PET/CT-guided and saturation template biopsy (3.1 ± 0.3 h after PET). The activity in biopsy cores was measured as counts per minute (cpm) in a gamma spectrometer. Pearson’s test was used to correlate counts with histopathology (WHO/ISUP), tumor length, and membranous PSMA expression on immunohistochemistry (IHC). Results In 43 of 113 needles, PCa was present. The mean cpm was overall significantly higher in needles with PCa (263 ± 396 cpm) compared to needles without PCa (73 ± 44 cpm, p < 0.001). In one patient with moderate PSMA uptake (SUVmax 8.7), 13 out of 24 needles had increased counts (100–200 cpm) but only signs of inflammation and PSMA expression in benign glands on IHC. Excluding this case, ROC analysis resulted in an AUC of 0.81, with an optimal cut-off to confirm PCa at 75 cpm (sens/spec of 65.1%/87%). In all 4 patients with PCa, the first or second PSMA PET-guided needle was positive for sigPCa with high counts (156–2079 cpm). Conclusions [18F]PSMA-1007 uptake in PCa can be used to confirm accurate lesion sampling of the dominant tumor intraoperatively. This technique could improve confidence in imaging-based biopsy guidance and reduce the need for saturation biopsy. Trial registration number NCT03187990, 15/06/2017.

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PET/CT-Guided Biopsy in Pancreatic Lesions

Oncological PET/CT with Histological Confirmation ◽

10.1007/978-3-319-27880-3_7 ◽

2016 ◽

pp. 77-86

Author(s):

Juliano J. Cerci ◽

Mateos Bogoni ◽

Dominique Delbeke

Keyword(s):

Ct Guided ◽

Guided Biopsy ◽

Pet Ct ◽

Ct Guided Biopsy

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68Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

Journal of Nuclear Medicine ◽

10.2967/jnumed.119.235333 ◽

2020 ◽

Vol 61 (9) ◽

pp. 1314-1319

Author(s):

Chen Liu ◽

Teli Liu ◽

Zhongyi Zhang ◽

Ning Zhang ◽

Peng Du ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Biopsy ◽

Ultrasound Guided ◽

Negative Biopsy ◽

Psma Pet ◽

Pet Ct ◽

Clinically Significant

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PET/CT-guided biopsy with respiratory motion correction

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-019-02047-4 ◽

2019 ◽

Vol 14 (12) ◽

pp. 2187-2198 ◽

Cited By ~ 1

Author(s):

Ruoqiao Zhang ◽

Dženan Zukić ◽

Darrin W. Byrd ◽

Andinet Enquobahrie ◽

Adam M. Alessio ◽

...

Keyword(s):

Motion Correction ◽

Respiratory Motion ◽

Ct Guided ◽

Respiratory Motion Correction ◽

Guided Biopsy ◽

Pet Ct ◽

Ct Guided Biopsy

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Should CT-guided biopsy for suspected lung cancer be delayed pending PET/CT results?

10.1183/13993003.congress-2016.pa4673 ◽

2016 ◽

Cited By ~ 2

Author(s):

Paul Griffiths ◽

Joanne Heaton ◽

Sarah Claxton

Keyword(s):

Lung Cancer ◽

Ct Guided ◽

Guided Biopsy ◽

Pet Ct ◽

Ct Guided Biopsy

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Prostate-specific membrane antigen (PSMA) PET-CT guided radiotherapy in oligometastatic prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.213 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 213-213

Author(s):

Benedikt Engels ◽

Ozan Cem Guler ◽

Cem Onal ◽

Mark De Ridder

Keyword(s):

Prostate Cancer ◽

Lymph Nodes ◽

Pelvic Bone ◽

Prostate Specific Membrane Antigen ◽

Ct Guided ◽

Castration Resistant ◽

Psma Pet ◽

Pet Ct ◽

Oligometastatic Prostate Cancer ◽

Specific Membrane

213 Background: Metastases-directed therapy by metastasectomy or radiotherapy (RT) might delay disease progression and postpone systemic treatment in patients with oligometastatic prostate cancer. Here, we evaluated retrospectively the efficacy and toxicity of 68Ga prostate-specific membrane antigen (PSMA) PET-CT guided radiotherapy (RT) in the treatment of oligometastatic prostate cancer. Methods: A total of 23 prostate cancer patients with biochemical relapse, of which 13 castration-sensitive and 10 castration-resistant, were treated with intensity-modulated and image-guided RT (IMRT-IGRT) on ≤ 3 metastases detected by 68Ga PSMA PET-CT. Androgen deprivation therapy was continued in castration-resistant patients. Local control (LC), progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Results: A total of 38 metastases were treated. Involved sites were pelvic bone (n = 16), pelvic lymph nodes (n = 11), para-aortic lymph nodes (n = 6), ribs (n = 3) and vertebral body (n = 2). The median PSA prior to RT was 1.06 ng/ml (range 0.10 – 29.0 ng/ml). A median dose of 43.5 Gy (range, 30-64 Gy) was delivered by IMRT-IGRT in 12-27 fractions. At a median follow-up of 7 months (range, 2-17 months), 19 patients (83%) are in remission. Four patients (17%) developed distant recurrence. The actuarial 1-year LC, PFS and OS rates were 100%, 51% (95% CI 8-83%) and 100%. Castration-sensitive patients displayed a statistically significantly superior PFS on univariate analysis as compared to castration-resistant patients (1-year PFS 67% vs 0%, p < 0.01). One patient experienced grade 2 acute gastro-intestinal toxicity. No grade 3 or more toxic events were observed. Conclusions: By providing optimal LC, low toxicity and a promising PFS in castration-sensitive patients, the current retrospective study illustrated that 68Ga PSMA PET-CT guided RT may be an attractive treatment option in patients with oligometastatic prostate cancer. Validation by randomized trials is eagerly awaited.

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Simultaneous 18F-FDOPA PET/CT-Guided Biopsy and Radiofrequency Ablation of Recurrent Neuroendocrine Hepatic Metastasis

Clinical Nuclear Medicine ◽

10.1097/rlu.0000000000000765 ◽

2015 ◽

Vol 40 (6) ◽

pp. e334-e335 ◽

Cited By ~ 6

Author(s):

Alessio Imperiale ◽

Julien Garnon ◽

Philippe Bachellier ◽

Afshin Gangi ◽

Izzie Jacques Namer

Keyword(s):

Radiofrequency Ablation ◽

Hepatic Metastasis ◽

Ct Guided ◽

Guided Biopsy ◽

Pet Ct ◽

Ct Guided Biopsy

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Positron emission tomography/computed tomography-guided percutaneous trans-pararectal space prostate biopsy for the diagnosis of prostate cancer: A retrospective study

10.21203/rs.2.17523/v3 ◽

2020 ◽

Author(s):

Nana Luo ◽

Dan Ruan ◽

Yi-zhen Pang ◽

Qi-hang Shang ◽

Hao-jun Chen ◽

...

Keyword(s):

Prostate Cancer ◽

Computed Tomography ◽

Positron Emission Tomography ◽

Prostate Biopsy ◽

Fdg Pet ◽

Emission Tomography ◽

Ct Guided ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background Biopsy is considered the gold-standard technique for prostate cancer diagnosis and is recommended in patients with a high clinical indication of prostate cancer. In this study, we aimed to determine the diagnostic efficacy of a novel positron emission tomography (PET)/computed tomography (CT)-guided percutaneous trans-pararectal space-based approach to targeted prostate biopsy.Methods PET/CT-guided percutaneous trans-pararectal space prostate biopsies were performed in 14 consecutive patients with indications of prostate cancer. Whole-body 18 F-FDG PET/CT indicated the presence of 18 F-fluorodeoxyglucose (FDG)-avid focal prostate lesions. Two tissue specimens were obtained from each patient. The final diagnoses were established based on the results of a histopathological analysis and clinical follow-up, and these findings were used to verify the diagnostic accuracy of 18 F-FDG PET/CT for prostate cancer.Results The diagnostic accuracy of 18 F-FDG PET/CT for prostate cancer was 81.8%. Further analyses of the two biopsied samples per patient led to confirmed histopathological and immunohistochemical diagnoses of prostate cancer in all 14 patients. Consequently, the success rate of PET/CT-guided percutaneous trans-pararectal space prostate-targeted biopsy for the diagnosis of prostate cancer was 100.0% (14/14). Regarding safety, the average duration of biopsy was 20 min, and no serious complications occurred.Conclusions PET/CT-guided percutaneous trans-pararectal space prostate biopsy may yield a new approach to targeted prostate biopsy for the diagnosis of prostate cancer. Moreover, this biopsy procedure can be performed safely without complications, and is more cost-effective than conventional trans-rectal and trans-perineal prostate biopsy methods.

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Concordance of PD-L1 Status Between Image-Guided Percutaneous Biopsies and Matched Surgical Specimen in Non-Small Cell Lung Cancer

Frontiers in Oncology ◽

10.3389/fonc.2020.551367 ◽

2021 ◽

Vol 10 ◽

Author(s):

Liang Zhao ◽

Peiqiong Chen ◽

Kaili Fu ◽

Jinluan Li ◽

Yaqing Dai ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Ct Guided ◽

Tissue Sections ◽

Image Guided ◽

Guided Biopsy ◽

Pet Ct ◽

Ct Guided Biopsy ◽

Lung Biopsies

ObjectiveProgrammed death-ligand 1 (PD-L1) expression status is a crucial index for identifying patients who will benefit from anti-programmed cell death protein 1 (PD-1)/PD-L1 therapy for non-small cell lung cancer (NSCLC). However, the concordance of Tumor Proportion Score (TPS) between biopsies and matched surgical specimens remains controversial. This study aims to evaluate the concordance of PD-L1 expression between image-guided percutaneous biopsies and matched surgical specimens.MethodWe evaluated 157 patients diagnosed with operable NSCLC on both surgical tissue sections and matched lung biopsies retrospectively. The patients underwent either regular computed tomography (CT)-guided biopsy (n = 82) or positron emission tomography (PET)/CT-guided biopsy (n = 75). The concordance between surgical specimens and lung biopsies for PD-L1 TPS was evaluated using Cohen’s kappa (κ) coefficient.ResultsImmunohistochemical expression of PD-L1 was evaluated in both surgical resected specimens and matched biopsies in the eligible 138 patients. The concordance rate of PD-L1 expression between surgical tissue sections and matched biopsies was fairly high at 84.1% (116/138), and the κ value was 0.73 (95% CI: 0.63–0.83, P < 0.001). The concordance rate was higher for tissue sections from PET/CT-guided biopsy than for tissue sections from CT-guided biopsy [88.6% (62/70, κ value: 0.81) vs 79.4% (54/68, κ value: 0.66)].ConclusionPD-L1 TPS was strongly concordant between surgical specimens and matched lung biopsies. Thus, the routine evaluation of PD-L1 expression in diagnostic percutaneous biopsies could be reliable for identifying patients who will benefit from anti-PD-1/PD-L1 immunotherapy.

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