{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:58:12Z","timestamp":1785308292273,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nucl. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We evaluated whether Magnetic Resonance Imaging (MRI)-Derived T Stage independently predicts nodal disease on Prostate-Specific Membrane Antigen (PSMA) PET\/CT in patients with high-risk primary prostate cancer, and developed a predictive model for clinical decision support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>MRI-derived T Stage, Prostate-Specific Antigen (PSA), Gleason score, age and PSMA node status were analysed using univariable and multivariable logistic regression in 152 men with high-risk primary prostate cancer who underwent pre-treatment multiparametric MRI and PSMA PET\/CT. Model performance was assessed with area under the receiver operating characteristic (ROC) curve (AUC), calibration plots, and decision curve analysis. Subgroup analyses evaluated Gleason 3\u2009+\u20094 and 4\u2009+\u20093 disease separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MRI T3b and T4 stages were independently and significantly associated with increased risk of PSMA-positive nodal disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016, respectively). T3a disease was not significantly independently associated with PSMA-positive nodal disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.086). T3b remained an independent predictor even in Gleason 4\u2009+\u20093 cases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026; odds ratio\u2009\u2248\u200923.57). The final model (AUC\u2009=\u20090.863) was well-calibrated and demonstrated clinical net benefit on decision curve analysis. In our cohort, patients with PSA\u2009&amp;lt;\u200920\u2005ng\/mL, MRI-derived T2 disease, and Gleason score &amp;lt; 8 (including both 3\u2009+\u20094 and 4\u2009+\u20093 patterns) demonstrated a 0% rate of PSMA-positive nodal disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRI-derived T stage T3b disease is a strong independent predictor of PSMA-positive nodal disease. These findings support guideline-based staging criteria and support the integration of MRI-derived T Stage into PSMA PET\/CT triage workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnume.2026.1854064","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:58:07Z","timestamp":1785304687000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI-derived T stage predicts nodal positivity on PSMA PET\/CT in high-risk primary prostate cancer"],"prefix":"10.3389","volume":"6","author":[{"given":"Michael","family":"Courtney","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, St. James\u2019s Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Whiriskey","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, St. James\u2019s Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciaran","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, St. James\u2019s Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Sheehy","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, St. James\u2019s Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12957-025-03733-1","article-title":"Global burden of prostate cancer: age-period-cohort analysis from 1990 to 2021 and projections until 2040","volume":"23","author":"Chu","year":"2025","journal-title":"World J Surg Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.14740\/wjon1191","article-title":"Epidemiology of prostate cancer","volume":"10","author":"Rawla","year":"2019","journal-title":"World J Oncol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B4","doi-asserted-by":"publisher","first-page":"100993","DOI":"10.1016\/j.currproblcancer.2023.100993","article-title":"Advances in high-risk localized prostate cancer: staging and management","volume":"47","author":"Reina","year":"2023","journal-title":"Curr Probl Cancer"},{"key":"B5","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.eururo.2024.03.027","article-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer-2024 update. 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