Diepeveen, Dominique (2025) Prostate-specific Membrane Antigen Positron-Emission Tomography/Computed Tomography (PSMA PET/CT) demonstrates a high diagnostic accuracy in the primary detection of prostate cancer with high-risk features: PEACH-study approach in clinical practice. thesis, Medicine.
Full text available on request.Abstract
Introduction: Prostate cancer (PCa) forms a significant global health challenge, with current diagnostics relying heavily on PSA-screening and multiparametric MRI (mpMRI). The PEACH-study showed that at PSA-values of 20-50 ng/mL, PSMA PET/CT-scanning and PSMA-targeted biopsy provide accurate and efficient detection of PCa, without MRI-scan. The current study evaluates the reproducibility of the PEACH-study in a real-world clinical setting. Methods: This study analyzed biopsy-naive patients who underwent PSMA PET/CT-imaging and transperineal PSMA PET/CT-guided biopsy without prior MRI between August 2023 and December 2024. Patients were retrospectively included based on the criteria of the PEACH-study (PSA-level of 20-50 ng/mL). The diagnostic performance of PSMA PET/CT-guided biopsy for the detection of PCa and clinically significant PCa (csPCa ISUP ≥2) was evaluated. The maximum standardized uptake value (SUVmax) of suspicious prostate lesions and its predictive value for prostate biopsy outcomes was assessed. Results: Thirty-six men were included (median age 73 years and median PSA-level 29.0 ng/mL). Thirty-one (86%) patients had PSMA PET/CT-imaging with positive suspicion of PCa, whereas five patients (14%) had negative findings. A total of 11/36 (31%) men had metastatic disease on staging with PSMA PET/CT. PSMA-targeted biopsy detected PCa in 28/31 (90%) PSMA-positive patients with 27 of them (87%) having csPCa. Median SUVmax was 14.3 MBq (IQR 9.6 - 29.4), with no significant differences among ISUP-grade groups. Conclusion: PSMA PET/CT-guided biopsy demonstrated a high detection rate for csPCa in this real-world cohort, reinforcing PEACH-study findings. Its integration as a primary diagnostic tool could streamline the PCa diagnostic pathway at PSA-values > 20 ng/mL, combining diagnosis and staging within a single scan and thereby reducing reliance on mpMRI. Further studies are needed to establish the place of PSMA PET/CT in clinical practice.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cauberg, Evelyne and Rynja, Sybren and Noordzij, Arjen and Boer, Jouke |
| Faculty: | Medical Sciences |
| Date Deposited: | 18 Feb 2026 14:21 |
| Last Modified: | 18 Feb 2026 14:21 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3894 |
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