proPSMA: PSMA PET-CT versus conventional imaging for staging high-risk prostate cancer
PSMA PET-CT was 27 percentage points more accurate than CT and bone scan for finding spread in men with high-risk prostate cancer before treatment, with less radiation and more influence on management, and it has replaced conventional imaging where available.
Overview
Randomised multicentre trial of 302 men with high-risk localised prostate cancer randomised to conventional imaging (CT and bone scan) or gallium-68 PSMA PET-CT for staging, with crossover imaging to define a reference standard.
Accuracy was 92 percent for PSMA PET-CT against 65 percent for conventional imaging, with higher sensitivity (85 versus 38 percent) and specificity, fewer equivocal results, lower radiation dose and more frequent management change.
- Accuracy 92 percent vs 65 percent (27 percent absolute difference).
- Sensitivity 85 percent vs 38 percent; specificity 98 percent vs 91 percent.
PSMA PET-CT is the preferred staging investigation for high-risk prostate cancer and for biochemical recurrence, though most treatment trials were designed with conventional imaging.
- Reference standard relied partly on imaging follow-up rather than histology.
- Detecting more disease does not by itself prove better outcomes.
Similar pages
not linked directly; found by shared links- AgentCopper-64 SAR-bisPSMA
Shares Localised prostate cancer, high and very high risk, Biochemical recurrence of prostate cancer, Gallium-68.
- TrialBiodistribution and Dosimetry of Ga-68 P16-093 in Prostate Cancer
Shares Biochemical recurrence of prostate cancer, Gallium-68.
- InstitutionPeter MacCallum Cancer Centre
Shares Rodney J. Hicks, proPSMA.
- TrialLuTectomy
Shares Localised prostate cancer, high and very high risk, Gallium-68.
- IdeaPSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer
Shares Biochemical recurrence of prostate cancer, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha.
- PersonThomas A. Hope
Shares PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha, Gallium-68.
- PersonMichael Hofman
Shares proPSMA, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha.
- OpportunityGRPR imaging when the PSMA scan is negative
Shares Biochemical recurrence of prostate cancer, Gallium-68.