Prospective comparison of whole-body MRI and 68Ga-PSMA PET/CT for the detection of BCR of prostate cancer after radical prostatectomy.

[tango65]

"68Ga-PSMA PET/CT significantly out-performed wb-MRI in the detection of biochemical recurrence in Pca patients after radical prostatectomy."

ncbi.nlm.nih.gov/pubmed/308...

[cesanon]

It would be better if they had added some pet/CT scans into the mix.

It seems like no one hardly does MRI for prostate cancer

[Hidden in reply to cesanon]

There is also a MRI with 68 GA PSMA, less radiation and quite equivalent.

if PSMA PET CT first, they do a very, very focused MRI to see morphological anomalies (and can then radiate very accurately).

[Hidden]

Yes, it is the best exam! BUT we have to be careful, there are false positives. My husband had 3 PSMA PET CT and they still are not sure 100% about his bone mets. They did another long long MRI (1.5 hours) and now think 1 point in the spine is osteoporosis, ribs still not sure and pelvis 2 points maybe...

And that after 1 year from dx!! Must say alternative medicine probably stopped progression so if mets the progression is not what they expect...

What I understand is that after PSMA PET CT locates spots they do a very, very focused MRI to see morphological anomalies (and can then radiate very accurately).

I know from other cases with false positives that affected the choice of therapies here in Switzerland. Here they are doing the scans before any therapy.

[tango65 in reply to Hidden]

All imagining techniques have false postives. The important thing here is the iamount of false negatives with the MRI studies. We have made extremely costly studies using wrong information. Many non metastatic patients included in many of the studies with the diagnosis made with MRI, most probably were metastatic. I believe that this is why this information is important.

[Hidden in reply to tango65]

yes, but with exams getting better, also the concept of metastasis is changing. There is no more clear line, and also the concept of oligometastatic changes. There are also the micro metastasis not catched by PSMA. It seems that maybe the idea of naturopaths, that think when you can see a tumor it is already spread, is not so false and there is not black and white, but it is more of a gradually thing, so that therapy choices will have to adapt.