Background: The aim of this study was to evaluate the role of histopathological and biochemical parameters in the prediction of the presence and number of PSMA positive lesions consistent with the metastatic spread of prostate cancer on 68 Ga-PSMA PET images.Methods: Biochemical, histopathological and imaging data of 302 prostate cancer patients who underwent 68 Ga-PSMA-11 PET/CT or PET/MR imaging for primary staging were retrospectively analyzed. Patients were divided into two groups as "PET positive" and "PET negative" according to the presence of pathologic extraprostatic PSMA involvement. "PET positive" patients were additionally divided into two groups: oligometastatic (1-3 metastatic lesion) and multimetastatic (>3 metastatic lesions).Results: The mean age of patients was 66.8 ± 7.6 years. Imaging modality was PET/ MR in 223 (73.8%) and PET/CT in 79 (26.2%) of patients. Total PSA, PSA density (PSAD), ALP, and tumor ratio in biopsy specimens were found to be significantly higher in "PET positive" group compared to "PET negative" group and in multimetastatic group compared to oligometastatic group. PET positivity was observed in 3.8% of the low-intermediate risk groups (ISUP 1-3 and total PSA ≤ 20 ng/ml and PSAD < 0.15 ng/ml/cc). This ratio was 46% in the high-risk group (ISUP 4-5 or total PSA > 20 ng/ml or PSAD ≥ 0.15 ng/ml/cc) with a relative risk of 12 (p < .001). The prediction models to predict the PET positivity and the presence of distant metastasis had AUCs of 0.901 and 0.925, respectively; with ALP, total PSA, and tumor ratio in needle biopsy specimen as significant independent predictors (p < .05).Conclusions: In this study, 68 Ga-PSMA-11 PET positivity was significantly higher in the high-risk patient group than in the low-intermediate risk groups. The prediction models used for predicting the PET positivity and the presence of distant metastasis on PET imaging were successful with high discriminatory powers. In addition to total
We retrospectively reviewed and compared the results of corporal plication procedures for the correction of congenital penile curvature (CPC) between pre‐pubertal and post‐pubertal boys and find whether age matters in the success rates. We reviewed the records of 32 patients with CPC without hypospadias treated by simple plication near the 12 o'clock position between 1998 and 2018 in our clinic. Patients under 13 years of age and not had puberty yet were accepted as pre‐pubertal. Residual curvature less than 10° during follow‐up was accepted as a surgical success. The mean age of the pre‐pubertal group was 8.3 (2–12) years, while 16.2 (14–21) for the post‐pubertal patients. The mean follow‐up was 38.7 (24–154) months in the pre‐pubertal group and 45.1 (23–150) months in the post‐pubertal group. The success rates of corporal plication in pre‐pubertal and post‐pubertal groups were 78% and 83% respectively (p = .753). The success rates of corporal plication were similar between pre‐pubertal and post‐pubertal boys. However, as the series was small further studies should be favoured to determine the effect of age on success rates.
The use of risk-stratification models and nomograms is common in urological oncology practice. 1 Prostate cancer treatment is a pioneer in this regard, and numerous risk calculators and predictive models have been created with clinical parameters, novel biomarkers (prostatic health index, prostate cancer antigen-3, SelectMDx) and magnetic resonance imaging (MRI) findings for the decision-making process in diagnosis, staging, treatment and follow-up. 2 Targeted biopsy has become the new standard approach in MRIpositive patients with the widespread usage of multiparametric MRI (mpMRI) in the diagnosis of prostate cancer. Performing mpMRI is recommended for patients with prostate biopsy indication in current European Association of Urology guidelines, whether they are biopsy naïve or not. 3 The rationale is to prevent unnecessary biopsies, which are invasive procedures with possible complications, and to prevent overdiagnosis and overtreatment by recognising clinically significant cancer. However, Prostate Imaging Reporting and Data System (PI-RADS) scoring, which was first defined in 2012 4 and last updated in 2019, 5 seems to be insufficient alone in preventing
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