PSMA-PET Reliable for Prostate Cancer Detection in Radical Prostatectomy

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-12-06T17:00:19+05:30 | Updated On 6 Dec 2023 5:00 PM IST

A recent study toward more precise prostate cancer detection found the potential of PSMA-PET (prostate-specific membrane antigen-positron emission tomography) in biopsy-free radical prostatectomy. According to the study, this procedure relies on prior biopsies, but the PSMA-PET approach could revolutionize this norm. The findings of the research were published in the Journal of Urology.

This retrospective study analyzed the intersection of PSMA-PET, benign prostatic hyperplasia (BPH), and prostate cancer. The major concern was the expression of PSMA in BPH tissue, which could lead to false positives. The study, a first in its kind, unveiled a BPH-related false-positive rate of 30% in PSMA-PET's detection of prostate cancer.

The research also found the significance of the maximum standardized uptake value (SUVmax) and the Prostate Imaging Reporting & Data System (PI-RADS) in steering biopsy-free radical prostatectomy. The SUVmax emerged as a critical parameter, effectively excluding BPH and low-grade prostate cancer patients. An optimal SUVmax cutoff value of 15 exhibited 100% specificity but with a sensitivity of 41%.

The stringent PET scores and PI-RADS criteria (both ≥4) showed promising results in diagnosing clinically significant prostate cancer, achieving a sensitivity of 49% and 100% specificity.

These findings mark a significant step toward biopsy-free radical prostatectomy while caution is warranted. The study underscores the need for further research, especially in large-scale clinical trials, to solidify the efficacy and safety of PSMA-PET in managing prostate cancer. As discussions on the broader implications of this breakthrough unfold, the patients are reminded to prioritize evidence-based, standard-of-care treatments until a clearer consensus emerges.

Reference:

Tang, W., Tang, Y., Qi, L., Zhang, Y., Tang, G., Gao, X., Hu, S., & Cai, Y. (2023). Benign Prostatic Hyperplasia–Related False-Positive of Prostate-Specific Membrane Antigen–Positron Emission Tomography in the Diagnosis of Prostate Cancer: The Achilles’ Heel of Biopsy-Free Radical Prostatectomy? In Journal of Urology (Vol. 210, Issue 6, pp. 845–855). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/ju.0000000000003680

Journal of Urologybenign prostatic hyperplasiaPSMA-PET

Source : Journal of Urology

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751