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Title: Patterns of primary staging for newly diagnosed prostate cancer in the era of prostate specific membrane antigen positron emission tomography: A population-based analysis.
Austin Authors: Papa, Nathan;Perera, Marlon ;Murphy, Declan G;Lawrentschuk, Nathan;Evans, Melanie;Millar, Jeremy L;Bolton, Damien M 
Affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia
Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Alfred Health Radiation Oncology Services, Melbourne, Victoria, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Surgery (University of Melbourne)
Olivia Newton-John Cancer Wellness and Research Centre
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Issue Date: Oct-2021
Date: 2021-03-05
Publication information: Journal of Medical Imaging and Radiation Oncology 2021; 65(6): 649-654
Abstract: There has been a growing body of evidence highlighting the improved sensitivity and specificity for prostate specific membrane antigen (PSMA) positron emission tomography (PET) in advanced prostate cancer imaging. We aimed to assess prostate cancer staging practice patterns in Australia using population-based data. We extracted data on men diagnosed with prostate cancer between October 2016 and December 2018 from the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic). We evaluated trends and comparisons between patients receiving PET/CT (with or without conventional imaging (CImg)), and CImg alone, and analysed imaging modality as predictor of clinical regional node positive disease (cN1 vs cN0/X), metastatic disease (cM1 vs cM0/X), and treatment received. In total, 6139 patients in the registry had either a staging PET scan (n = 889, 14%), CImg without PET scan (n = 2464, 40%), or no recorded PET or CImg (n = 2786, 45%). The proportion of allimaged patients who received staging PET increased from 19% to 36% from the first to last three-month period, and in the high-risk category the increase was 23-43%. After adjustment for grade group, PET vs CImg-only patients were observed to have a higher proportion of cN1 disease (OR = 2.46, 95% CI: 1.90-3.20) but not cM1 disease (OR = 1.10, 95% CI: 0.84-1.44). Our registry data highlights the rapid uptake of PET imaging, particularly in high-risk disease. Based on this data, we highlight the increased diagnosis of nodal disease, thus potentially optimizing patient selection prior to definitive treatment for prostate cancer.
DOI: 10.1111/1754-9485.13162
ORCID: 0000-0002-1138-6389
Journal: Journal of Medical Imaging and Radiation Oncology
PubMed URL: 33666330
Type: Journal Article
Subjects: imaging
positron emission tomography
Prostate cancer
prostate specific membrane antigen
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