SNMMI: 18F-Piflufolastat PSMA PET/CT Offers High PPV for Local PCa Recurrence Regardless of PSA Level

The use of ¹⁸F-piflufolastat PSMA PET/CT demonstrates consistently high positive predictive value (PPV) for local prostate cancer recurrence across a range of prostate-specific antigen (PSA) levels, according to new research presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) conference.

For a sub-analysis from the 2021 CONDOR study, researchers reviewed ¹⁸F-piflufolastat PSMA PET scans for 208 men with a median PSA of 0.8 ng/mL with 47 men from this cohort (median PSA ranging between 4 to 4.3 ng/mL) having at least one positive lesion in the prostate or prostatic bed. Of the 47 men with positive lesions, 21 had radiation therapy only, 15 had a radical prostatectomy and 11 men had both definitive treatments, according to the study.

In a recent interview at the SNMMI conference, study co-author Amir Iravani noted consistent PPV values for ¹⁸F-piflufolastat PSMA PET/CT, ranging from 77 to 83 percent, for the detection of prostate or prostate bed recurrence across PSA levels ranging between > 5 ng/mL to < 0.5 ng/mL.

“ … This study shows, regardless of the PSA, even at the very low PSA, the positive predictive value remained high, and across all the strata of the PSA value, even when it's very low below 0.5 ng/mL. … Even when we look at the sub-analysis of the patients who had prostatectomy or radiotherapy, in both settings, positive predictive value remained very high,” noted Dr. Iravani, an associate professor of radiology at the University of Washington and theranostics director at the Fred Hutch Cancer Center in Seattle.

(Editor’s note: For related content, see “SNMMI: Can 18F-Fluciclovine PET/CT Bolster Detection of PCa Recurrence in the Prostate Bed?,” “What a New PSMA PET/CT Study Reveals About Local PCa Treatment and High-Risk Recurrence” and “SNMMI: What a New Meta-Analysis Reveals About Radiotracers for PET/CT Detection of PCa.”)

For more insights from Dr. Iravani, watch the video below.

Reference

1. Chappidi MR, Iravani A, Stambler N, et al. 18F-piflufolastat PET/CT in patients with biochemically recurrent prostate cancer: a CONDOR sub-analysis of positive predictive value in the prostate/prostatic bed stratified by PSA. Presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) conference, June 21-24, 2025, New Orleans. Available at: https://poster.econference.io/app/snmmi/B95p18u/poster/145658 .