Unambiguous radiologic extranodal extension determined by MRI could be a biomarker in predicting metastatic prostate cancer

• Published in: Radiologia medica Vol. 128; no. 5; pp. 520 - 527
• Main Authors: Han, Ye, Shen, Fan, Jiao, Jianhua, Xiao, Zunjian, Qin, Weijun, Ren, Jing, Huan, Yi
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.05.2023; Springer Nature B.V
• Subjects: Abdominal Radiology; Aged; Biomarkers; Diagnostic Radiology; Extranodal Extension - pathology; Humans; Imaging; Interventional Radiology; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Metastasis; Neoplasm Staging; Neuroradiology; Nuclear medicine; Performance prediction; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Radiology; Retrospective Studies; Standard deviation; Ultrasound; Bone metastasis; Radiologic extranodal extension; MRI; Prostate cancer
• ISSN: 1826-6983; 0033-8362; 1826-6983
• DOI: 10.1007/s11547-023-01631-8

Objective To explore the relationship between unambiguous radiologic extranodal extension (rENE) and M1 staging in patients with metastatic PCa. Methods A respective analysis of 1073 patients of PCa N1 staging from January 2004 to May 2022 was retrospectively enrolled. They were divided into rENE + and rENE −  groups and retrospectively analyzed the M staging with nuclear medicine data. The correlation index between unambiguous rENE and M1b staging was calculated. Logistic regression was used to evaluate the predictive performance of unambiguous rENE in M1b staging. ROC curves were used to investigate the relationship between unambiguous rENE and M staging in patients who underwent 68  Ga-PSMA PET/CT. Results A total of 1073 patients were included. Seven hundred and eighty patients were classified into the rENE + group (mean age, 69.6 years ± 8.7 [standard deviation]), and 293 were classified into rENE −  group (mean age, 66.7 years ± 9.4 [standard deviation]). Relationship between unambiguous rENE and M1b existed ( r  = 0.58, 95%CI: 0.52–0.64, P  < 0.05). Unambiguous rENE could be an independent predictor for M1b (OR = 13.64, 95%CI: 9.23–20.14, P  < 0.05). The AUC of unambiguous rENE in predicting M1b and M staging was 0.835 and 0.915, respectively, in patients who underwent 68  Ga-PSMA PET/CT. Conclusions Unambiguous rENE could be a strong biomarker to predict M1b and M staging in patients with PCa. When rENE came up, patients should perform nuclear medicine immediately, and a systematic treatment should be considered.