Utility of Ga68 prostate-specific membrane antigen positron-emission tomography for pre-operative staging of high-risk prostate cancer in a prospective cohort.

INTRODUCTION: To assess the yield of Ga68 PSMA PET/CT added to the conventional staging of high-risk prostate cancer in terms of altered staging and changes to management. METHODS: Patients with high-risk prostate cancer without metastatic disease on conventional staging referred for Ga68 PSMA PET/CT at Mercy Radiology, Auckland, New Zealand, were prospectively recruited. Conventional staging was double read in a blinded fashion by oncology fellowship-trained radiologists, who were also experienced in PET/CT, followed by interpretation of the PSMA PET/CT by the same radiologists. Confirmation of changes in management decision was obtained from the treating surgeon and multidisciplinary team meeting records. Ethical approval was obtained from the Health and Disability Ethics Committee. All patients gave written informed consent. RESULTS: A total of 49 patients were scanned. Three who were otherwise eligible for radical prostatectomy elected alternative treatments, leaving 46 patients included for analysis in the study. The addition of PSMA PET/CT was associated with highly statistically significant changes in both staging and management. The stage was changed in 32.6% (95% CI 20.8-47.1%, P < 0.001) patients upstaging in 60% and downstaging in 40%; clinical management in 34.8% (95% CI 22.6-49.3%; P < 0.001), with intramodality change in 25% and intermodality change in 75%. Factors predictive of a change in management with PSMA PET/CT included higher Gleason score and a greater proportion of prostatic cores positive for tumour. CONCLUSION: The addition of Ga68 PSMA PET/CT to conventional staging in high-risk prostate cancer frequently leads to changes in staging and management.

Dissemination of results from medical student public health research training and factors associated with publication.

PURPOSE: To examine factors associated with successful publications resulting from mandatory public health research training attachment, the Trainee Intern Health Care Evaluation (TIHE) projects, at the University of Otago, Dunedin School of Medicine, New Zealand. METHODS: A total of 227 TIHE projects completed during the period from January 1985 to December 2013 were included in the study. In February 2016, Medline and Google Scholar databases were searched independently by both authors for publications using predefined search criteria. RESULTS: Overall, 25 (11.1%) out of 227 projects resulted in 19 articles, 3 conference presentations/abstracts and 4 cited report abstracts. Nineteen (8.4%) projects resulted in 22 peer-reviewed journal publications, the majority of which were original articles (86.4%). The number of projects commissioned by a client was independently associated with the likelihood of publication, conference abstract or citation of the project report (OR 1.40; P<0.01, 95% CI 1.14 to 1.71). The number of authors and the number of non-student authors were positively associated with publication in higher impact journals, while student first-authored articles were more likely to be published in lower impact journals. Projects completed in more recent years were more likely to be published. CONCLUSIONS: Mandatory medical student research experiences promote tangible research output. These findings may help to influence policy around the introduction of required medical school research and facilitate encouraging academic careers among medical students. Future research could focus on examining how different student-related, supervisor-related and programme-related factors influence publication rates from mandatory medical student research attachments.