Fluorine-18 prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (18F-PSMA-1007 PET/CT) outperforms multiparametric magnetic resonance imaging (mpMRI) for pretreatment staging of intermediate- and high-risk prostate most cancers, investigators report.
In a section 2 research of 134 males present process radical prostatectomy, preoperative 18F-PSMA-1007 PET/CT recognized the ultimate pathologic tumor stage in a considerably better proportion of males than mpMRI: 45% vs 28%, Adam Kinnaird, MD, PhD, of the College of Alberta in Edmonton, Alberta, Canada, and colleagues reported in JAMA Oncology.
PSMA PET additionally extra precisely recognized the dominant nodule (94% vs 83%), laterality (64% vs 44%), and extracapsular extension (75% vs 63%) in contrast with mpMRI. PSMA PET confirmed improved sensitivity (58% vs 33%) and nonetheless had excessive specificity (each 90%) for extracapsular extension in contrast with MRI. PSMA PET additionally had larger sensitivity for unilateral vs bilateral illness (69% vs 39%) however at decrease specificity (27% vs 93%).
Identification of seminal vesicle invasion was comparable between imaging modalities: 91% vs 85%. Radiologists and nuclear drugs physicians had been blinded to prior biopsy outcomes.
The understaging price was 64% when utilizing MRI in contrast with 41% with PSMA PET, the investigators reported.
Nobody skilled opposed occasions.
“Based mostly on our findings and people beforehand revealed for metastatic staging, the adoption of a single preoperative PSMA PET scan might probably substitute the trio of preoperative typical imaging checks presently ordered (MRI, CT stomach and pelvis, and bone scan) in sure sufferers with intermediate-risk and high-risk prostate most cancers,” Dr Kinnaird’s crew wrote.
The investigators famous that radioligand 18F-PSMA-1007 has excessive PSMA affinity, larger spatial decision, and longer half-life than gallium 68 radioligands, in addition to minimal urinary excretion.
