Related Experiment Video
Updated: Jun 27, 2025
A Whole Body Dosimetry Protocol for Peptide-Receptor Radionuclide Therapy PRRT: 2D Planar Image and Hybrid 2D+3D SPECT/CT Image Methods
Published on: April 24, 2020
A Comparison of Globally Applied Prognostic Risk Groups and the Prevalence of Metastatic Disease on Prostate-specific
Wietske I Luining1, Liselotte M S Boevé2, Marinus J Hagens3
1Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam, The Netherlands; Prostate Cancer Network the Netherlands, Amsterdam, The Netherlands.
Risk classification systems for prostate cancer (PCa) need refinement. Further subdividing intermediate- and high-risk groups improves detection of metastatic disease using PSMA-PET/CT staging.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Prostate cancer (PCa) risk classification systems (RCSs) stratify patients prognostically.
- Accurate risk stratification is crucial for guiding treatment decisions and staging.
Purpose of the Study:
- To compare the predictive value of different prognostic subgroups within RCSs for detecting metastatic disease on PSMA-PET/CT.
- To assess the benefit of further subdividing risk groups for improved staging accuracy.
Main Methods:
- Retrospective analysis of 2630 newly diagnosed PCa patients who underwent PSMA-PET/CT (2017-2022).
- Patients were stratified using four RCSs: EAU, NCCN, CPG, and CAPRA.
- Prevalence of metastatic disease on PSMA-PET/CT was compared across subgroups.
Main Results:
- Metastatic disease was observed in 35% of all patients.
- Prevalence of metastases in intermediate- and high-risk groups ranged from 12% to 46%.
- NCCN and CPG systems, when further subdivided, showed distinct metastatic rates (e.g., NCCN: 5.8% to 62% across risk levels).
Conclusions:
- Nuanced risk stratification is essential for accurate PCa staging.
- Subdividing intermediate- and high-risk categories is recommended due to significant variations in metastatic disease prevalence.
- PSMA-PET/CT for primary staging should be prioritized for patients with unfavorable intermediate- or higher-risk disease.
