PSMA-PET/CT May Detect Prostate Cancer More Accurately Than mpMRI

PSMA-PET/CT with the radiotracer 18F-DCFPyl (¹⁸F-PSMA PET/CT) may improve detection of prostate lesions compared with multiparametric MRI (mpMRI) in men with suspected prostate cancer, according to a poster presentation at the 36th annual European Association of Urology virtual congress.

In the PEDAL trial, 54 men (median age 66 years) with a median PSA level of 6.15 ng/mL completed both imaging modalities. Results showed that ¹⁸F-PSMA PET/CT (SUVmax 7.0 or higher) detected 40 lesions, whereas prostate mpMRI detected 35 lesions graded PIRADS 3 or greater, Vy Tran, MD, of St Vincent’s Hospital in Melbourne, Australia, and colleagues reported. A total of 25 lesions were detected on both mpMRI and ¹⁸F-PSMA PET/CT.

Of 34 men who underwent prostate biopsy, 25 were found to have prostate cancer. The investigators compared imaging results with findings from targeted prostate biopsy in these 25 men. A per-lesion analysis showed that 17 of the 25 (73.8%) lesions with clinically significant prostate cancer (Grade group 2 or higher) were visualized with both imaging modalities. All clinically significant lesions identified by mpMRI were visualised on PET/CT, but ¹⁸F-PSMA PET/CT identified 3 (13%) additional lesions, the investigators reported. Further, ¹⁸F-PSMA PET/CT identified 11 patients with metastatic disease.

“18F-DCFPyl PSMA-PET/CT is able to detect prostate lesions seen on mpMRI prostate, as well as identify additional clinically significant lesions,” Dr Tran’s team concluded in their study abstract. “The ability of PSMA-PET/CT to diagnose metastatic disease also saves the need for further staging following diagnosis. These early results provide promising evidence for a fully-powered trial to follow.”

Reference

Tran V, Sutherland T, Taubman K, et al. Preliminary results from the PEDAL trial: a prospective single arm paired comparison of ability to diagnose and locate prostate cancer between multiparametric MRI and 18F-PSMA-PET/CT. Presented at the EAU 2021 virtual conference, July 8-12, 2021. Abstract P0910.