MRI better at detecting PC than PSMA Pet

[treedown]

news-medical.net/news/20220...

I know this is for the detection so not as clear for us farther into the path but still worth considering IMO.

[Justfor_]

Their numbers are not convincing. 141 patients had MRI findings. 82 out of all biopsied (181) had PCa. Even at the extremely favourable assumption that all 82 had MRI findings, ie there was not even a single one out of the 198 with PSMA detection that missed MRI while having PCa, the sensitivity of MRI is 58% (82/141). How they boosted it up to 75% remains a mystery.

[tango65]

This is a study designed to diagnose PC localized in the prostate only.

The results are not surprising since the PSMA ligand they used is eliminated by the urine and the collection of the ligand in the bladder makes difficult to visualized the cancer in the prostate. Despite of this handicap the PSMA PET/CT studies identified correctly high grade tumors in the prostates.

"It also showed that PSMA PET/CT was not inferior to MRI in the detection of clinically significant cancers (ISUP 2 and higher); and since the ultimate goal of primary staging will be to detect only the more aggressive cancers and avoid unnecessary biopsy, this is not the end of the story. More research will be needed to explore the PSMA PET/CT correlation between the standard uptake value (SUV) and cancer aggressiveness, but the first steps down the road in finding the best diagnostic approach to clinically significant prostate cancer have been taken."

There are other PSMA ligands (PSMA 1007) which are not eliminated by the urine and they may offer a more precise diagnosis of PC in the prostate and in other parts of the body.

[Tony666]

Psma pet scans are most useful in detecting prostate cancer outside the prostate. MRI scans are most useful in detecting it within the prostate.

[Cooolone]

In other words, PSMA Pet scans become more efficient for patients who are recurrent. Not so much for newly diagnosed patients unless there's suspicion of distant metastasis. It yes, it's still the most sensitive, in the right setting.

Good luck!

[treedown in reply to Cooolone]

That was my take as well. If I had been diagnosed 3 years later I would have had access to better scans. As it was MRI and CT was best insurance would pay for.