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Prostate-Specific Membrane Antigen PET Bests MRI in Biochemical Recurrent Disease

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PSMA PET is highly robust in identifying prostate cancer lesions which are otherwise deemed unremarkable.

68Ga prostate specific membrane antigen (PSMA) positron emission tomography (PET) has high utility in the detection of suspicious lesions in biochemically recurrent prostate cancer. This is according to study results presented at the Radiological Society of North America (RSNA) 2021 Annual Meeting.

“PSMA PET is a more robust modality for biochemical recurrence with the potential of identifying small lesions which would otherwise be dismissed on MRI alone,” the authors wrote. “We recommend the use of 68Ga PSMA PET/MR for biochemical recurrent prostate cancer with potential to be the new standard of care for this indication.”

The results were presented by Juana Martinez, M.D., fellow in radiology at Weill Cornell Medical College in New York. 

PSMA PET combined with magnetic resonance imaging (MRI) is a promising technique in the evaluation of patients with prostate cancer. In this study, the researchers compared PSMA PET with concomitant multiparametric MRI in detecting lesions suspicious for biochemical prostate cancer recurrence. 

A review was performed of all patients with prostate cancer who prospectively enrolled in a clinical trial of 68Ga PSMA PET/MRI at New York Presbyterian Hospital - Weill Cornell campus from April 2018 to January 2021. Nuclear medicine physicians read the PSMA PET portion of the study and a radiologist with fellowship training in cancer imaging read the MRI of the skull base to thigh, independent of each other. Patient demographics, the indication for PSMA PET/MRI and serum prostate specific antigen (PSA) levels closest to the PSMA PET/MRI were extracted from patient charts.

Of the 165 patients who had a PSMA PET/MRI, 109 where imaged for biochemical recurrence. PSMA PET was able to detect more lesions suspicious for recurrence than MRI at all PSA levels. When assessing only patients who had PSMA PET/MRI for biochemical recurrent disease, PSMA PET fared superiorly at all PSA levels in comparison with MRI. 

“When compared with MRI, PSMA PET is highly robust in identifying lesions which are otherwise deemed unremarkable,” the authors wrote.

For more coverage of RSNA 2021, click here.

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