Background: Gallium-68-prostate-specific membrane antigen ( 68 Ga-PSMA) positron emission tomography/computed tomography (PET/CT) has recently been shown to be very high accuracy in biopsy-naïve prostate cancer (PCa) detection and can potentially improve the low specificity noted with diffusion-weighted magnetic resonance imaging (DW-MRI), especially in instances of prostate inflammation. We aimed to compare the diagnostic accuracy of DW-MRI and PSMA PET/CT using apparent diffusion coefficient (ADC) and maximum standardized uptake (SUV max ) values in the diagnosis of PCa. Patients and Methods: A retrospective study comparing and analyzing the diagnostic accuracy of prebiopsy DW-MRI and 68 Ga-PSMA PET/CTs done in patients with suspected PCa (raised prostate specific antigen [PSA] and/or positive digital rectal examination) from January 2019 to December 2020. The standard of reference was transrectal ultrasound-guided biopsies. Results: Sixty-seven patients were included in the study, mean age: 70 years (range 49–84), mean PSA: 23.2 ng/ml (range 2.97–45.6). Biopsy was positive for PCa in 56% ( n = 38) and negative in 43% ( n = 29). Of the benign results, benign hyperplasia was noted in 75% ( n = 22) and prostatitis in 25% ( n = 7). Of the PCa, 55% ( n = 21) of were high International Society of Urological Pathology (ISUP) grade (4–5) and 45% ( n = 17) low/intermediate ISUP grade (1–3). Overall the sensitivity/specificity/Accuracy for prediction of PCa of MRI using prostate imaging and reporting data system version 2 criteria and PSMA PET/CT using PCa molecular imaging standardized evaluation criteria was 92.1%/65.5%/80.5% and 76.3%/96.5%/85.1% respectively. Mean apparent diffusion co-efficient (mean ADC) value of benign lesions and PCa was 1.135 × 10 -3 mm 2 /s and 0.723 × 10 -3 mm 2 /s, respectively ( P = 0.00001). Mean SUV max and ADC of benign and PCa lesions was 4.01 and 16.4 ( P = 0.000246). Mean SUV max /ADC ratio of benign and malignant lesions was 3.8 × 103 versus 25.21 × 103 ( P < 0.000026). Inverse correlation was noted between ADC and SUV max values ( R = −0.609), inverse correlation noted between ADC and Gleason's score ( R = −0.198), and positive correlation of SUV max and SUV max /ADC with Gleason's score ( R = 0.438 and R = 0.448). Receiver operating characteris...

Background and Aim Prior knowledge of axillary node status can spare a lot of patients with early breast cancer morbidity due to an unnecessary axillary dissection. Our study compared various metabolic and pathological features that can predict the sentinel lymph node biopsy (SLNB) status in patients with positron emission tomography/computed tomography (PET/CT) negative axilla. Patients and Methods All consecutive patients with early breast cancers (< 5 cm) with PET/CT negative axilla who underwent breast surgery and SLNB from November 2016 to February 2020 were included. Various primary tumor (PT) pathological variables and metabolic variables on PET/CT such as maximum standardized uptake value (PT-SUVmax), metabolic tumor volume (PT-MTV), and total lesion glycolysis (PT-TLG) were compared using univariate and multivariate analyses for prediction of SLNB status. Results Overall 70 patients, all female, with mean age 55.6 years (range: 33–77) and mean tumor size 2.2 cm (range: 0.7–4.5), were included. SLNB was positive in 20% of patients (n = 14) with nonsentinel nodes positive in 4% (n = 3) patients. Comparing SLNB positive and negative groups, univariate analysis showed significant association of SLNB with low tumor grade, positive lymphovascular invasion (LVI), positive estrogen receptor (ER) status with lower mean Ki-67 index (34.41 vs. 52.02%; p = 0.02), PT-SUVmax (5.40 vs. 8.68; p = 0.036), PT-MTV (4.71 cc vs. 7.46 cc; p = 0.05), and PT-TLG (15.12 g/mL.cc vs. 37.10 g/mL.cc; p = 0.006). On multivariate analysis, only LVI status was a significant independent predictor of SLNB status (odds ratio = 6.23; 95% confidence interval: 1.15–33.6; p = 0.033). Conclusion SLNB is positive in approximately 20% of early breast cancers with PET/CT negative axilla and SLNB status appears to be independent of PT size. SLNB+ PTs were more likely to be LVI+ and ER + ve, with lower grade/Ki-67/metabolic activity (SUVmax/MTV/TLG) compared with SLNB–ve tumors. Logistic regression analysis revealed LVI status as the only significant independent predictor of sentinel lymph node status.

No abstract

No abstract