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How do you check for a prostate cancer recurrence? Prostate-specific membrane antigen (PSMA) PET/MRI can predict whether prostate cancer is likely to return.

In men recently diagnosed with intermediate or high-grade prostate cancer, prostate-specific membrane antigen (PSMA) PET/MRI can successfully determine whether their cancer is likely to return within two years of a prostate removal surgery.

Armed with this information, physicians can identify patients who could benefit from additional treatment and/or frequent surveillance. This research was published in the Journal of Nuclear Medicine.

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Prostate cancer is known to have very variable behavior and outcomes. While many cases of localized prostate cancer can be treated successfully, some patients experience a rapid progression even after surgery or radiation therapy.

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‘Functional imaging such as PET/MRI is increasingly being considered as a way to identify patients at risk for recurrent prostate cancer.’

Therefore, initial risk stratification is important to determine treatment decisions and subsequent management of prostate cancer patients.

Clinicians currently use biopsy findings and clinical information, such as prostate-specific antigen (PSA) levels, to predict if prostate cancer is slow-growing or if it will spread quickly and require aggressive treatments.

Improving Prediction of Prostate Cancer Recurrence using Imaging

In the study, researchers examined the value of 68Ga-PSMA-11 PET/MRI for risk stratification of newly diagnosed prostate patients before initiating therapy.

Seventy-three patients with a new diagnosis of intermediate- or high-grade prostate cancer were imaged with 68Ga-PSMA-11 PET/MR between April 2016 and December 2020.

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PET findings were divided into groups based on low versus high uptake in the primary lesion and the presence or absence of metastatic disease.

These findings were compared to biopsy results and clinical information. The relationship between the PET/MRI findings and patient outcomes was also examined.

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High uptake in the primary lesion and the presence of PSMA metastasis were associated with biochemical failure or rapid recurrence within two years after surgery.

In contrast, patients with low uptake in the primary lesion who did not have evidence of metastatic disease on PET/MRI had a low likelihood of experiencing recurrence during the follow-up period.

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PSMA PET/MRI adds value to the pre-therapy evaluation of patients with newly diagnosed prostate cancer, and the information from PET seems to be as reliable, if not more reliable, than biopsy findings and clinical information in predicting which patients will have a suboptimal outcomes.

Source-Eurekalert