⁶⁸Ga-PSMA PET/CT Bests mpMRI in Detecting High-Risk Prostate Cancer

WEDNESDAY, Feb. 23, 2022 (HealthDay News) — ⁶⁸Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) improves detection of high-risk prostate cancer (PCa) compared with multiparametric magnetic resonance imaging (mpMRI), while for low- and intermediate-risk PCa, mpMRI has superior diagnostic accuracy, according to a study published online Feb. 11 in EJNMMI Research.

Chuanchi Zhou, from The Third Xiangya Hospital in Changsha, China, and colleagues conducted a retrospective analysis of 101 patients who had undergone prostate biopsy and/or radical prostatectomy and had been scanned with ⁶⁸Ga-PSMA PET/CT, and mpMRI. The mpMRI images were scored with the Prostate Imaging-Reporting and Data System Version 2.1 (PI-RADS) and were classified as positive or negative (PI-RADS 1 to 3 or 4 to 5, respectively); ⁶⁸Ga-PSMA PET/CT lesions were classified by nuclear medicine physicians.

The researchers found that 88 and 85 of the patients presented with a pathologic mpMRI and pathologic ⁶⁸Ga-PSMA PET/CT, respectively. ⁶⁸Ga-PSMA PET/CT was positive in 64 of 66 patients with high-risk PCa and yielded a higher detection rate than mpMRI (58 of 66 patients; 97% vs. 87.9%). For identifying low- and intermediate-risk PCa, mpMRI provided superior diagnostic confidence (30/35 [85.7%] versus 21/35 [60%]). A higher uptake of PSMA was more likely to occur in lesions of low- and intermediate-risk PCa when the age threshold exceeded 62.5 years and the serum prostate-specific antigen threshold exceeded 9.4 ng/mL.

“These results may help decide whether patients with low- and intermediate-risk PCa require a prostate biopsy or further management,” the authors write. “Further prospective studies are warranted to confirm our findings.”

Abstract/Full Text