The Blind Spot of Prostate-Specific Membrane Antigen Positron Emission Tomography Staging? Intraductal Carcinoma of the Prostate Is Overrepresented in Patients With No Uptake Pattern on Prostate-Specific Membrane Antigen Positron Emission Tomography and High-Grade Prostate Cancer

Abstract

Purpose: – Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is increasingly used to diagnose and stage prostate cancer. A PRIMARY score uses anatomical localization and uptake patterns to improve diagnostic accuracy. We evaluated the histopathology of patients with no uptake pattern (PRIMARY score 1) and the prevalence of intraductal carcinoma of the prostate (IDC-P) in this subset compared with those with an uptake pattern (PRIMARY score ≥2).Materials and Methods: – A 2-center, retrospective cohort study was conducted including consecutive patients imaged with intraprostatic [68Ga]Ga-PSMA-11 or [18F]DCFPyL PSMA PET before radical prostatectomy. All PSMA PET scans..