Advanced Imaging Reveals Undetected Metastases in High-Risk Prostate Cancer Patients: Study Finds - Video
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Overview
A new study published in JAMA Network Open found that nearly half of high-risk prostate cancer patients previously classified as nonmetastatic by conventional imaging actually have metastatic disease when evaluated with advanced prostate-specific membrane antigen–positron emission tomography (PSMA-PET) imaging, suggesting that traditional imaging may underestimate how far the cancer has spread in many cases. The findings are published in JAMA Network Open.
To better understand the advantages of PSMA-PET over conventional imaging, researchers conducted a post hoc, retrospective cross-sectional study using data from 182 patients with high-risk recurrent prostate cancers who were thought to have disease limited to the prostate and were eligible for the EMBARK trial.
This clinical trial previously demonstrated that adding enzalutamide, a type of hormone therapy, to androgen deprivation therapy significantly improves metastasis-free survival. However, the trial relied on conventional imaging to classify patients, which researchers believe might have underestimated the disease's extent in some cases.
The researchers found PSMA-PET detected cancer metastases in 46% of patients, even though traditional imaging had suggested no evidence of cancer spread. Based on PSMA-PET, 24% of the patients even showed 5 or more lesions that had been missed by conventional imaging.
This advanced imaging technology plays a critical role in redefining how prostate cancer is staged. PSMA-PET imaging uses tiny amounts of radioactive “tracers,” called radiotracers, that binds to prostate cancer cells, making them visible on PET scans.
Reference: Holzgreve A, Armstrong WR, Clark KJ, et al. PSMA-PET/CT Findings in Patients With High-Risk Biochemically Recurrent Prostate Cancer With No Metastatic Disease by Conventional Imaging. JAMA Netw Open. 2025;8(1):e2452971. doi:10.1001/jamanetworkopen.2024.52971
Speakers
Dr. Bhumika Maikhuri
BDS, MDS
Dr. Bhumika Maikhuri is a medical correspondent with Medical Dialogues. She holds a BDS from Dr. D.Y. Patil Dental College and an MDS in Orthodontics from Kalinga Institute of Dental Sciences. She regularly contributes articles on dental and general health topics, including fact checks, expert features, and public health updates. Her strong clinical and research background ensures depth and credibility in her writing.