PSMA-based F-DCFPyL PET: a better choice than multiparametric MRI for prostate cancer diagnosis?

Owing to the high tissue contrast, multiparametric MRI (mpMRI) has already been the most widely applied imaging method for prostate cancer. Recently, prostate-specific membrane antigen (PSMA) ligands for nuclear imaging are emerging as a promising modality in prostate cancer, especially since the 2 PET/CT agents (Ga-PSMA-11 and F-DCFPy) approved by U.S. Food and Drug Administration (FDA). However, limited studies have performed the comparison of mpMRI versus recently approved F-DCFPyL PET/CT. In this issue of AJNMMI, Lu et al. compared the performance of F-DCFPyL PET/CT and pelvic mpMRI in intermediate-high risk and biochemical recurrent prostate cancer patients. The results demonstrated the two modalities have a good concordance rate for patient-based analysis, and F-DCFPyL PET/CT has a better diagnostic performance in detecting lymph node metastases and bone metastases for lesion-based analysis. The use of F-DCFPyL PET/CT provides more diagnostic confidence to better assess prostate cancer lesions.