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Guidotti A, Lombardo R, De Nunzio C. Re: James P. Buteau, Daniel Moon, Michael T. Fahey, et al. Clinical Trial Protocol for PRIMARY2: A Multicentre, Phase 3, Randomised Controlled Trial Investigating the Additive Diagnostic Value of [ 68Ga]Ga-PSMA-11 Positron Emission Tomography/Computed Tomography in Men with Negative or Equivocal Multiparametric Magnetic Resonance Imaging for the Diagnosis of Clinically Significant Prostate Cancer. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2023.11.008. Eur Urol Oncol 2024; 7:1156-1157. [PMID: 38570238 DOI: 10.1016/j.euo.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Alessio Guidotti
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy.
| | - Riccardo Lombardo
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy
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2
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Fan N, Chen X, Li Y, Zhu Z, Chen X, Yang Z, Yang J. Dual-energy computed tomography with new virtual monoenergetic image reconstruction enhances prostate lesion image quality and improves the diagnostic efficacy for prostate cancer. BMC Med Imaging 2024; 24:212. [PMID: 39134937 PMCID: PMC11321013 DOI: 10.1186/s12880-024-01393-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Prostate cancer is one of the most common malignant tumors in middle-aged and elderly men and carries significant prognostic implications, and recent studies suggest that dual-energy computed tomography (DECT) utilizing new virtual monoenergetic images can enhance cancer detection rates. This study aimed to assess the impact of virtual monoenergetic images reconstructed from DECT arterial phase scans on the image quality of prostate lesions and their diagnostic performance for prostate cancer. METHODS We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People's Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40-100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images. RESULTS Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P < 0.001). The 50 keV images also demonstrated elevated CT values (121.73 ± 39.21) compared to conventional images (P < 0.001). CNR values for the 40 keV (3.81 ± 2.13) and 50 keV (2.95 ± 1.50) groups were significantly higher than the conventional blending group (P < 0.001). Subjective evaluations indicated markedly better image quality scores for 40 keV (median score of 5) and 50 keV (median score of 5) images compared to conventional images (P < 0.05). ROC curve analysis revealed superior diagnostic accuracy for 40 keV (AUC: 0.910) and 50 keV (AUC: 0.910) images based on CT values compared to conventional images (AUC: 0.849). CONCLUSIONS Virtual monoenergetic images reconstructed at 40 keV and 50 keV from DECT arterial phase scans substantially enhance the image quality of prostate lesions and improve diagnostic efficacy for prostate cancer.
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Affiliation(s)
- Nina Fan
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China
| | - Xiaofeng Chen
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China
| | - Yulin Li
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China
| | - Zhiqiang Zhu
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China
| | - Xiangguang Chen
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China
| | - Zhiqi Yang
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China.
| | - Jiada Yang
- Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China.
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Spena G, Moretti TB, Dávila FS, Dos Anjos G, Khan I, Calace FP, Aveta A, Pandolfo SD, Tufano A, Izzo A, Farias A, Perdonà S, Maes K. Ga68-PSMA PET for lymph node staging in intermediate and high-risk prostate cancer patients undergoing robotic assisted radical prostatectomy. Minerva Urol Nephrol 2024; 76:467-473. [PMID: 39051893 DOI: 10.23736/s2724-6051.24.05736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND In intermediate/high risk prostate cancer, preoperative staging exams are mandatory. The aim of these imaging studies is to evaluate eventual lymph nodes involvement and/or metastatic spread of the tumor. Nevertheless, computed tomography (CT), magnetic resonance imaging (MRI), bone scan modalities have controversial sensitivity. Introduction of PET-PSMA and its use also as preoperative exam, seems to improve diagnostic accuracy due to favorable negative predictive value. The aim of this study was to evaluate the accuracy of PET-PSMA as a preoperative staging exam and its accuracy in predicting lymph nodes involvement in intermediate/high risk prostate cancer (PCa) patients. METHODS A retrospective analysis of 50 patients diagnosed with intermediate/high risk PCa between 2018 and 2022 has been performed. All patients underwent preoperative 68Ga-PSMA PET/CT prior to robot-assisted radical prostatectomy (RARP) + extended pelvic lymph node dissection (ePLND). The cohort was categorized into two groups: pathologically negative lymph nodes (pN0) vs. positive nodes (pN1). A descriptive and comparative analysis was conducted. Correlation analysis between continuous variables was performed using the Spearman's Rank Test. Using lymph nodes histopathological results as reference standard, the diagnostic performance of 68Ga-PSMA PET/CT was calculated. RESULTS Overall, 50 patients were included. The mean age was 63.3 years with a median prostatic specific antigen (PSA) of 7.7 ng/dL. Forty-four percent of the patients exhibited an International Society of Urological Pathology (ISUP) score of 4 or higher, and 28% had a pT3 stage. Overall, 43 (86%) patients submitted to ePLND did not present lymph node metastases (pN0), while 8 (14%) patients were pN1. PET-PSMA showed low sensitivity in detecting lymph node metastases (25%) while a high specificity in excluding lymph-node disease (88.1%) has been observed. Finally, we noted a significant positive correlation between the total SUVmax of the prostate and the initial total PSA (r=0.38; P=0.019), as well as the percentage of tumor involvement (r=0.383; P=0.022). CONCLUSIONS Evidence on the role of PET-PSMA in the primary staging of PCa is steadily building up. A positive correlation between SUV and prostate involvement indicates that PET-PSMA could reflect, with a good approximation, the pathological features of the prostate. However, the low sensitivity depicted remains the main limitation. Future prospective studies are needed to determine the impact on patient outcome.
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Affiliation(s)
- Gianluca Spena
- Department of Urology, Hospital Da Luz Lisboa, Lisbon, Portugal -
- Unit of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy -
| | - Tomás B Moretti
- Department of Urology, Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | | | - Gabriel Dos Anjos
- Department of Urology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ilaana Khan
- Department of Urology, Hospital Da Luz Lisboa, Lisbon, Portugal
| | | | - Achille Aveta
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Savio D Pandolfo
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Antonio Tufano
- Unit of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
- Department of Maternal-Child and Urological Sciences, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Alessandro Izzo
- Unit of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Artur Farias
- Department of Urology, Hospital Da Luz Lisboa, Lisbon, Portugal
| | - Sisto Perdonà
- Unit of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Kris Maes
- Department of Urology, Hospital Da Luz Lisboa, Lisbon, Portugal
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4
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Olivetta M, Manfredi C, Spirito L, Quattrone C, Bottone F, Stizzo M, Amicuzi U, Lecce A, Rubinacci A, Romano L, Della Rosa G, Papi S, Tammaro S, Coppola P, Arcaniolo D, Fusco F, De Sio M. Cognitive Targeted Prostate Biopsy Alone for Diagnosing Clinically Significant Prostate Cancer in Selected Biopsy-Naïve Patients: Results from a Retrospective Pilot Study. Diagnostics (Basel) 2024; 14:1643. [PMID: 39125520 PMCID: PMC11311372 DOI: 10.3390/diagnostics14151643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
(1) Background: To identify a particular setting of biopsy-naïve patients in which it would be reasonable to offer only cognitive targeted prostate biopsy (PBx) with a transrectal approach. (2) Methods: We designed an observational retrospective pilot study. Patients with a prostatic specific antigen (PSA) level > 10 ng/mL, either a normal or suspicious digital rectal examination (DRE), and a lesion with a PI-RADS score ≥ 4 in the postero-medial or postero-lateral peripheral zone were included. All patients underwent a transrectal PBx, including both systematic and targeted samples. The detection rate of clinically significant prostate cancer (csPCa) (Gleason Score ≥ 7) was chosen as the primary outcome. We described the detection rate of csPCa in systematic PBx, targeted PBx, and overall PBx. (3) A total of 92 patients were included. Prostate cancer was detected in 84 patients (91.30%) with combined biopsies. A csPCa was diagnosed in all positive cases (100%) with combined biopsies. Systematic PBxs were positive in 80 patients (86.96%), while targeted PBxs were positive in 84 men (91.30%). Targeted PBx alone would have allowed the diagnosis of csPCa in all positive cases; systematic PBx alone would have missed the diagnosis of 8/84 (9.52%) csPCa cases (4 negative patients and 4 not csPCa) (p = 0.011). (4) Conclusions: Cognitive targeted PBx with a transrectal approach could be offered alone to diagnose csPCa in biopsy-naïve patients with PSA ≥ 10 ng/mL, either normal or suspicious DRE, and a lesion with PI-RADS score ≥ 4 in the postero-medial or postero-lateral peripheral zone.
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Affiliation(s)
- Michelangelo Olivetta
- Department of Urology, AOU San Giovanni e Ruggi D’Aragona, G. Fucito Hospital, 84085 Mercato San Severino, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Carmelo Quattrone
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Francesco Bottone
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Marco Stizzo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Ugo Amicuzi
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy
| | - Arturo Lecce
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Andrea Rubinacci
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Lorenzo Romano
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Giampiero Della Rosa
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Salvatore Papi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Simone Tammaro
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Paola Coppola
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Ferdinando Fusco
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
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Dagnino F, Avolio PP, Fasulo V, Piccolini A, Aljoulani M, Moretto S, Maffei D, Finocchiaro A, Beatrici E, Paciotti M, Saita A, Lazzeri M, Hurle R, Buffi NM, Casale P, Lughezzani G. Clinically significant prostate cancer detection rate in biopsy-naïve patients with mpMRI and microultrasound topographically discordant lesions: A single-center retrospective analysis. Urol Oncol 2024:S1078-1439(24)00535-0. [PMID: 39068037 DOI: 10.1016/j.urolonc.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/04/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (mpMRI) has improved the detection of clinically significant prostate cancer (csPCa), and microultrasound (micro-US) shows promise in enhancing detection rates. We compared mpMRI-guided targeted biopsy (MTBx) and micro-US-guided targeted biopsy (micro-US-TBx) in biopsy-naïve patients with discordant lesions at micro-US and mpMRI to detect csPCa (grade group ≥2) and clinically insignificant PCa (ciPCa; grade group 1) and assessed the role of nontargeted systematic biopsy (SBx). MATERIAL AND METHODS We analyzed 178 biopsy-naive men with suspected PCa and discordant lesions at mpMRI and micro-US. All patients underwent mpMRI followed by micro-US, the latter being performed immediately before the biopsy. Imaging findings were interpreted blindly, followed by targeted and SBx. Median age was 63 years (IQR, 57-70), median prostate-specific antigen level was 7 ng/mL (IQR, 5-9 ng/mL), and median prostate volume was 49 cm^3 (IQR, 35-64 cm^3). Overall, 86/178 (48%) patients were diagnosed with PCa, 51/178 (29%) with csPCa. RESULTS Micro-USTBx detected csPCa in 36/178 men (20%; 95% CI: 26-46), and MTBx detected csPCa in 28/178 men (16%; 95% CI: 36-50), resulting in a -8% difference (95% CI: -10, 4; P = 0.022) and a relative detection rate of 0.043. Micro-USTBx detected ciPCa in 9/178 men (5%; 95% CI: 3, 15), while MTBx detected ciPCa in 12/178 men (7%; 95% CI: 5, 20), resulting in a -3% difference (95% CI: -2 to 4; P = 0.2) and a relative detection rate of 0.1. SBx detected ciPCa in 29 (16%) men. mpMRI plus micro-US detected csPCa in 51/178 men, with no additional cases with the addition of SBx. Similarly, MTBx plus micro-USTBx plus SBx detected ciPCa in 35/178 men (20%; 95% CI: 18, 37) compared to 9 (5%) in the micro-US pathway (P = 0.002) and 14/178 (8%; 95% CI: 6, 26) in the mpMRI plus micro-US pathway (P = 0.004). CONCLUSIONS In conclusion, a combined micro-US/mpMRI approach could characterize primary disease in biopsy-naïve patients with discordant lesions, potentially avoiding SBx. Further studies are needed to validate our findings and assess micro-US's role in reducing unnecessary biopsies.
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Affiliation(s)
- Filippo Dagnino
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Pier Paolo Avolio
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Vittorio Fasulo
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Andrea Piccolini
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Muhannad Aljoulani
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Stefano Moretto
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Davide Maffei
- Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Alessio Finocchiaro
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Edoardo Beatrici
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Marco Paciotti
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy
| | - Alberto Saita
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy
| | - Massimo Lazzeri
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy
| | - Rodolfo Hurle
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy
| | - Nicolò M Buffi
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
| | - Paolo Casale
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy.
| | - Giovanni Lughezzani
- Department of Urology, Humanitas Research Hospital - IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University -Pieve Emanuele, Italy
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6
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Sanders JL, Iczkowski KA, Shah GV. Predicting the Diagnosis of Prostate Cancer with a Novel Blood-Based Biomarker: Comparison of Its Performance with Prostate-Specific Antigen. Cancers (Basel) 2024; 16:2619. [PMID: 39123347 PMCID: PMC11311074 DOI: 10.3390/cancers16152619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/13/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
The purpose of this study was to assess the efficacy, specificity, and predictive value of a newly discovered biomarker, Zinc finger-like1 protein (referred to as neuroendocrine marker, NEM) for the detection of prostate cancer (PCa). We retrospectively analyzed banked plasma samples from 508 men, with a median age of 67 years (range 48-97), to compare the performance of NEM and PSA in predicting subsequent histologic PCa. The cohort consisted of four groups of patients visiting a urology clinic: (1) patients not diagnosed with either benign prostatic disease or prostate cancer (PCa) were defined as normal; (2) patients diagnosed with benign hyperplasia (BPH) but not PCa; (3) patients with confirmed PCa; and (4) patients with cancer other than PCa. The normal men displayed a mean NEM plasma level of 0.948 ± 0.051 ng/mL, which increased to 1.813 ± 0.315 ng/mL in men with BPH, 86.49 ± 15.51 ng/mL in men with PCa, and 10.47 ± 1.029 ng/mL in men with other Ca. The corresponding concentrations of prostate-specific antigen (PSA) in these subjects were 1.787 ± 0.135, 5.405 ± 0.699, 35.77 ± 11.48 ng/mL, and 8.036 ± 0.518, respectively. Receiver operating characteristic (ROC) curve analysis was performed to compare NEM and PSA performance, and the Jouden Index for each biomarker was calculated to determine cut-off points for each biomarker. The area under the ROC curve to predict PCa was 0.99 for NEM and 0.81 for PSA (p < 0.0001). The cut-off for NEM was at 1.9 ng/mL, with sensitivity of 98% and specificity of 97%. The corresponding PSA values were 4.4 ng/mL, with sensitivity of 76% and specificity of 95%. The predictive value of each biomarker in a patient was matched with his pathologic data to determine the accuracy of each biomarker. NEM was more accurate than PSA in differentiating cancer from benign conditions, such as BPH or prostatitis. In conclusion, NEM was a better predictor of PCa than PSA in patients visiting urology clinics. NEM tests, either alone or in conjunction with other biomarkers, provide a reliable, non-invasive, and inexpensive test to remarkably reduce false positives and thereby reduce the number of diagnostic biopsies and associated painful procedures and the loss of quality of life.
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Affiliation(s)
- Johnmesha L. Sanders
- Pharmacology, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA;
| | - Kenneth A. Iczkowski
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California—Davis, Sacramento, CA 95817, USA;
| | - Girish V. Shah
- Pharmacology, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA;
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7
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Mari A, Cadenar A, Giudici S, Cianchi G, Albisinni S, Autorino R, Di Maida F, Gandaglia G, Mir MC, Valerio M, Marra G, Zattoni F, Bianchi L, Lombardo R, Shariat SF, Roupret M, Bauckneht M, Vaggelli L, De Nunzio C, Minervini A. A systematic review and meta-analysis to evaluate the diagnostic accuracy of PSMA PET/CT in the initial staging of prostate cancer. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00850-y. [PMID: 38822051 DOI: 10.1038/s41391-024-00850-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/04/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Positron Emission Tomography-Computed Tomography using Prostate-Specific Membrane Antigen (PSMA PET/CT) is notable for its superior sensitivity and specificity in detecting recurrent PCa and is under investigation for its potential in pre-treatment staging. Despite its established efficacy in nodal and metastasis staging in trial setting, its role in primary staging awaits fuller validation due to limited evidence on oncologic outcomes. This systematic review and meta-analysis aims to appraise the diagnostic accuracy of PSMA PET/CT compared to CI for comprehensive PCa staging. METHODS Medline, Scopus and Web of science databases were searched till March 2023. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. Primary outcomes were specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of PSMA PET/CT for local, nodal and metastatic staging in PCa patients. Due to the unavailability of data, a meta-analysis was feasible only for detection of seminal vesicles invasion (SVI) and LNI. RESULTS A total of 49 studies, comprising 3876 patients, were included. Of these, 6 investigated accuracy of PSMA PET/CT in detection of SVI. Pooled sensitivity, specificity, PPV and NPV were 42.29% (95%CI: 29.85-55.78%), 87.59% (95%CI: 77.10%-93.67%), 93.39% (95%CI: 74.95%-98.52%) and 86.60% (95%CI: 58.83%-96.69%), respectively. Heterogeneity analysis revealed significant variability for PPV and NPV. 18 studies investigated PSMA PET/CT accuracy in detection of LNI. Aggregate sensitivity, specificity, PPV and NPV were 43.63% (95%CI: 34.19-53.56%), 85.55% (95%CI: 75.95%-91.74%), 67.47% (95%CI: 52.42%-79.6%) and 83.61% (95%CI: 79.19%-87.24%). No significant heterogeneity was found between studies. CONCLUSIONS The present systematic review and meta-analysis highlights PSMA PET-CT effectiveness in detecting SVI and its good accuracy in LNI compared to CI. Nonetheless, it also reveals a lack of high-quality research on its performance in clinical T staging, extraprostatic extension and distant metastasis evaluation, emphasizing the need for further rigorous studies.
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Affiliation(s)
- Andrea Mari
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy.
| | - Anna Cadenar
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy
| | - Sofia Giudici
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy
| | - Gemma Cianchi
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy
| | - Simone Albisinni
- Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | - Fabrizio Di Maida
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy
| | - Giorgio Gandaglia
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - M Carmen Mir
- Department of Urology, Hospital Universitario La Ribera, Valencia, Spain
| | - Massimo Valerio
- Department of Urology, University Hospital of Geneva, Geneva, Switzerland
| | - Giancarlo Marra
- Division of Urology, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Fabio Zattoni
- Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, Padova, Italy
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Lombardo
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Weill Cornell Medical College, New York, NY, 10065, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- European Association of Urology Research Foundation, Arnhem, The Netherlands
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordanien
| | - Morgan Roupret
- Urology, Predictive Onco-Urology, AP-HP, Urology Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Luca Vaggelli
- Nuclear Medicine Division, Careggi University Hospital, Florence, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Andrea Minervini
- Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121, Florence, Italy
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8
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Fu Q, Luo L, Hong R, Zhou H, Xu X, Feng Y, Huang K, Wan Y, Li Y, Gong J, Le X, Liu X, Wang N, Yuan J, Li F. Radiogenomic analysis of ultrasound phenotypic features coupled to proteomes predicts metastatic risk in primary prostate cancer. BMC Cancer 2024; 24:290. [PMID: 38438956 PMCID: PMC10913270 DOI: 10.1186/s12885-024-12028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Primary prostate cancer with metastasis has a poor prognosis, so assessing its risk of metastasis is essential. METHODS This study combined comprehensive ultrasound features with tissue proteomic analysis to obtain biomarkers and practical diagnostic image features that signify prostate cancer metastasis. RESULTS In this study, 17 ultrasound image features of benign prostatic hyperplasia (BPH), primary prostate cancer without metastasis (PPCWOM), and primary prostate cancer with metastasis (PPCWM) were comprehensively analyzed and combined with the corresponding tissue proteome data to perform weighted gene co-expression network analysis (WGCNA), which resulted in two modules highly correlated with the ultrasound phenotype. We screened proteins with temporal expression trends based on the progression of the disease from BPH to PPCWOM and ultimately to PPCWM from two modules and obtained a protein that can promote prostate cancer metastasis. Subsequently, four ultrasound image features significantly associated with the metastatic biomarker HNRNPC (Heterogeneous nuclear ribonucleoprotein C) were identified by analyzing the correlation between the protein and ultrasound image features. The biomarker HNRNPC showed a significant difference in the five-year survival rate of prostate cancer patients (p < 0.0053). On the other hand, we validated the diagnostic efficiency of the four ultrasound image features in clinical data from 112 patients with PPCWOM and 150 patients with PPCWM, obtaining a combined diagnostic AUC of 0.904. In summary, using ultrasound imaging features for predicting whether prostate cancer is metastatic has many applications. CONCLUSION The above study reveals noninvasive ultrasound image biomarkers and their underlying biological significance, which provide a basis for early diagnosis, treatment, and prognosis of primary prostate cancer with metastasis.
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Affiliation(s)
- Qihuan Fu
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Li Luo
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Ruixia Hong
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Hang Zhou
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Xinzhi Xu
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Yujie Feng
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Kaifeng Huang
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Yujie Wan
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Ying Li
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Jiaqi Gong
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Xingyan Le
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Xiu Liu
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Na Wang
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China
| | - Jiangbei Yuan
- Department of Infection, Zhejiang Provincial People's Hospital, 310014, Hangzhou, China.
| | - Fang Li
- Department of Ultrasound, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC) , Chongqing University Cancer Hospital, 400030, Chongqing, China.
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9
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Beatrici E, Frego N, Chiarelli G, Sordelli F, Mancon S, Saitta C, De Carne F, Garofano G, Arena P, Avolio PP, Gobbo A, Uleri A, Contieri R, Paciotti M, Lazzeri M, Hurle R, Casale P, Buffi NM, Lughezzani G. A Comparative Evaluation of Multiparametric Magnetic Resonance Imaging and Micro-Ultrasound for the Detection of Clinically Significant Prostate Cancer in Patients with Prior Negative Biopsies. Diagnostics (Basel) 2024; 14:525. [PMID: 38472997 DOI: 10.3390/diagnostics14050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases. METHODS A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa). RESULTS In our cohort of 1397 men, 304 had a history of negative biopsies. mUS was more sensitive than mpMRI, with better predictive value for negative results. Importantly, mUS was significantly associated with csPCa detection (adjusted odds ratio [aOR]: 6.58; 95% confidence interval [CI]: 1.15-37.8; p = 0.035). CONCLUSIONS mUS may be preferable for diagnosing prostate cancer in previously biopsy-negative patients. However, the retrospective design of this study at a single institution suggests that further research across multiple centers is warranted.
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Affiliation(s)
- Edoardo Beatrici
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Nicola Frego
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giuseppe Chiarelli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Federica Sordelli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Stefano Mancon
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Fabio De Carne
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giuseppe Garofano
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Paola Arena
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Pier Paolo Avolio
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Andrea Gobbo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Alessandro Uleri
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Roberto Contieri
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Marco Paciotti
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
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10
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Lombardo R, Gallo G, Stira J, Turchi B, Santoro G, Riolo S, Romagnoli M, Cicione A, Tema G, Pastore A, Al Salhi Y, Fuschi A, Franco G, Nacchia A, Tubaro A, De Nunzio C. Quality of information and appropriateness of Open AI outputs for prostate cancer. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00789-0. [PMID: 38228809 DOI: 10.1038/s41391-024-00789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
Chat-GPT, a natural language processing (NLP) tool created by Open-AI, can potentially be used as a quick source for obtaining information related to prostate cancer. This study aims to analyze the quality and appropriateness of Chat-GPT's responses to inquiries related to prostate cancer compared to those of the European Urology Association's (EAU) 2023 prostate cancer guidelines. Overall, 195 questions were prepared according to the recommendations gathered in the prostate cancer section of the EAU 2023 Guideline. All questions were systematically presented to Chat-GPT's August 3 Version, and two expert urologists independently assessed and assigned scores ranging from 1 to 4 to each response (1: completely correct, 2: correct but inadequate, 3: a mix of correct and misleading information, and 4: completely incorrect). Sub-analysis per chapter and per grade of recommendation were performed. Overall, 195 recommendations were evaluated. Overall, 50/195 (26%) were completely correct, 51/195 (26%) correct but inadequate, 47/195 (24%) a mix of correct and misleading and 47/195 (24%) incorrect. When looking at different chapters Open AI was particularly accurate in answering questions on follow-up and QoL. Worst performance was recorded for the diagnosis and treatment chapters with respectively 19% and 30% of the answers completely incorrect. When looking at the strength of recommendation, no differences in terms of accuracy were recorded when comparing weak and strong recommendations (p > 0,05). Chat-GPT has a poor accuracy when answering questions on the PCa EAU guidelines recommendations. Future studies should assess its performance after adequate training.
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Affiliation(s)
| | - Giacomo Gallo
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Jordi Stira
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Beatrice Turchi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giuseppe Santoro
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Sara Riolo
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Matteo Romagnoli
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Cicione
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giorgia Tema
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Pastore
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Yazan Al Salhi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Fuschi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giorgio Franco
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Nacchia
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
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11
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Manfredi C, Ditonno F, Franco A, Bologna E, Licari LC, Arcaniolo D, Tubaro A, De Nunzio C, Antonelli A, De Sio M, Cherullo EE, Autorino R. Prostate Cancer in Transgender Women: Epidemiology, Clinical Characteristics, and Management Challenges. Curr Oncol Rep 2023; 25:1431-1443. [PMID: 37910274 DOI: 10.1007/s11912-023-01470-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW To systematically review the evidence on prostate cancer (PCa) in transgender women (TGW). RECENT FINDINGS A total of 25 studies were included. Fourteen articles were case reports or case series describing 21 TGW with PCa; 11 papers focused primarily on assessing the incidence or screening of PCa in TGW. The median (range) age of patients with PCa was 63 (45-78) years. Median (range) PSA at diagnosis was 7.5 (0.4-1710) ng/mL. Prostate biopsy detected ISUP 3-5 in 10 (67%) cases. T3-4 stages were described in 7 (64%) patients. Three (14.3%) cases of nodal involvement and 2 (9.5%) of metastases were reported at diagnosis. First-line therapy included radical prostatectomy or radiotherapy ± androgen deprivation therapy in 14 (74 %) subjects. Median (range) follow-up was 24 (2-120) months. A good response to first-line therapy was recorded in 8 (47.1%) cases. Median (range) incidence of PCa in TGW was 44.1 (4.34-140) cases per 100,000 person-years. PCa was significantly less frequent in TGW than in cisgender males (HR 0.4, 95% CI 0.2-0.9). Risk of death after PCa diagnosis was significantly higher in TGW compared to cisgender males (HR 1.91, 95% CI 1.06-3.45). TGW had lower lifetime PSA rates (48% vs. 64.6%, p = 0.048) than cisgender males. Few cases of PCa in TGW are currently reported. PCa seems significantly less frequent in TGW than in cisgender males; however, some data suggest a possible higher mortality in this cohort. TGW appear to have less access to PSA testing than cisgender men.
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Affiliation(s)
- Celeste Manfredi
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Ditonno
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Antonio Franco
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Eugenio Bologna
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
- Unit of Urology, Department of Maternal-Child and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Leslie Claire Licari
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
- Unit of Urology, Department of Maternal-Child and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Edward E Cherullo
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA.
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12
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Fang B, Zhu Y. Applying prediction models in clinical practice: the importance of fine details. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00734-7. [PMID: 37803242 DOI: 10.1038/s41391-023-00734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Bangwei Fang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Genitourinary Cancer Institute, Shanghai, 200032, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
- Shanghai Genitourinary Cancer Institute, Shanghai, 200032, China.
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