Australian study on PSMA PET/CT vs CT + bone scan (March 2020)

"Interpretation

PSMA PET-CT is a suitable replacement for conventional imaging, providing superior accuracy, to the combined findings of CT and bone scanning." [1]

"Conventional imaging using CT and bone scan has insufficient sensitivity when staging men with high-risk localised prostate cancer. We aimed to investigate whether novel imaging using prostate-specific membrane antigen (PSMA) PET-CT might improve accuracy and affect management.

Methods

In this multicentre, two-arm, randomised study, we recruited men with biopsy-proven prostate cancer and high-risk features at ten hospitals in Australia. Patients were randomly assigned to conventional imaging with CT and bone scanning or gallium-68 PSMA-11 PET-CT. First-line imaging was done within 21 days following randomisation. Patients crossed over unless three or more distant metastases were identified. The primary outcome was accuracy of first-line imaging for identifying either pelvic nodal or distant-metastatic disease defined by the receiver-operating curve using a predefined reference-standard including histopathology, imaging, and biochemistry at 6-month follow-up. This trial is registered with the Australian New Zealand Clinical Trials Registry, ANZCTR12617000005358."

[1] thelancet.com/journals/lanc...

[marnieg46]

Hi justfor. You might be interested in the information in this video from urotoday.

urotoday.com/center-of-exce...

[Hidden in reply to marnieg46]

Thanks marnieg.

Interesting secondary finding:

PSMA PET/CT delivers, to the patient, HALF the radiation as compared to the standard combo of CT plus bone scan.

[marnieg46 in reply to Hidden]

Yes justfor a win both ways....far better information and safer too. Pretty well first line SOC here after diagnosis and for ongoing monitoring later on. Hopefully this trial will help towards better acceptance for funding in the States.