Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used for primary staging in prostate cancer (PC), mainly because of its improved accuracy in detecting lymph node metastases compared with conventional imaging. However, the diagnostic benefit of PSMA PET/CT for detecting bone metastases is less well established. This study compares the diagnostic accuracy of F-PSMA PET/CT and F-NaF PET/CT for detecting bone metastases in patients newly diagnosed with PC. This prospective study included patients with histologically confirmed high-risk PC. All participants were referred from the department of urology to F-NaF PET/CT and underwent F-PSMA PET/CT within 3 weeks. Images were reviewed by 2 nuclear medicine physicians unaware of the results of the other imaging modality. Presence or absence of bone metastases and number of metastatic lesions were recorded. A reference standard was established at the patient level based on agreement between the 2 imaging modalities. In cases of concordance, both modalities were deemed correct. In cases of discordance, additional follow-up scans were performed. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated. In total, 160 participants were included. Sensitivity, specificity, and accuracy for detecting bone metastases at the patient level were 0.98, 0.99, and 0.99, respectively, for F-PSMA PET/CT, and 0.91, 1.00, and 0.97, respectively, for F-NaF PET/CT. No significant differences were found. The concordance rate of bone metastases between F-NaF and F-PSMA PET/CT at the patient level was observed in 154 patients (96.3%). F-PSMA PET/CT tended to identify more bone metastases per patient than F-NaF PET/CT. Both F-NaF and F-PSMA PET/CT exhibit high diagnostic accuracy for detecting bone metastases in newly diagnosed high-risk PC patients. F-PSMA PET/CT may detect additional metastatic lesions compared with F-NaF PET/CT. Subsequent F-NaF PET/CT may be redundant if no bone metastases are found on F-PSMA PET/CT.
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http://dx.doi.org/10.2967/jnumed.124.268275 | DOI Listing |
J Nucl Med
January 2025
Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark.
Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used for primary staging in prostate cancer (PC), mainly because of its improved accuracy in detecting lymph node metastases compared with conventional imaging. However, the diagnostic benefit of PSMA PET/CT for detecting bone metastases is less well established. This study compares the diagnostic accuracy of F-PSMA PET/CT and F-NaF PET/CT for detecting bone metastases in patients newly diagnosed with PC.
View Article and Find Full Text PDFEJNMMI Rep
January 2025
Department of Translational Medicine, Lund University, Lund, Sweden.
Background: Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). Previous studies have shown high heterogeneity in methods and results.
View Article and Find Full Text PDFEur J Nucl Med Mol Imaging
December 2024
Division of Urology, Department of Surgery, University of Alberta, Edmonton, Canada.
Purpose: Fluorine-18 prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (F-PSMA-1007 PET/CT) has been shown to be superior to multiparametric magnetic resonance imaging (MRI) for the locoregional staging of intermediate-risk and high-risk prostate tumors. This study aims to evaluate whether it is also superior in estimating tumor parameters, such as three-dimensional spatial localization and volume.
Methods: 134 participants underwent F-PSMA-1007 PET/CT and MRI prior to radical prostatectomy as part of the validating paired-cohort Next Generation Trial (NCT05141760).
Br J Cancer
December 2024
PET/CT Center, The First Affiliated Hospital of Xi' an Jiaotong University, Xi' an, China.
Background: The diagnostic utility of prostate biopsy is limited for prostate cancer (PCa) in the prostate-specific antigen (PSA) grey zone. This study aims to evaluate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for PSA grey zone PCa and clinically significant PCa (csPCa).
Methods: A total of 82 patients with PSA levels ranging from 4 to 10 ng/mL who underwent F-PSMA-1007 PET/CT, mpMRI, and prostate biopsy were prospectively enrolled.
Prostate Cancer Prostatic Dis
December 2024
Department of Urology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Background: Prostate biopsy is the most common approach for diagnosing prostate cancer (PCa); however, it has inherent limitations, such as the invasive procedure, postoperative complications, and false negative results. We aimed to provide a noninvasive diagnostic strategy for patients with highly suspected PCa and to evaluate the feasibility of performing biopsy-spared radical prostatectomy.
Methods: This prospective study included a total of 57 patients between November 10, 2022, and December 1, 2023.
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