Comparing Imaging Modalities in Detecting Biochemical Recurrence of Prostate Cancer
Posted: Thursday, September 26, 2019
A prospective, comparative study from researchers at the University of California Los Angeles (UCLA) has found that detection rates of prostate cancer recurrence are significantly lower with the imaging system 18F-fluciclovine positron-emission tomography–computed tomography (PET-CT) than with prostate-specific membrane antigen (PSMA) imaging PET-CT. The study results, published in The Lancet Oncology, suggest that although the fluciclovine PET-CT is currently the standard of care in the United States, the alternative imaging approach may achieve higher detection rates.
Jeremie Calais, MD, of UCLA, and colleagues tested 50 men who had all had radical prostatectomy to treat prostate cancer, all of whom showed early-stage recurrence. The men also had low prostate-specfic antigen concentrations (< 2 ng/mL). The investigators used both imaging approaches and sent the results of the scans to three independent physician readers.
The results showed that PSMA imaging detected cancer recurrence in 56% of the scans, whereas fluciclovine PET-CT was able to detect recurrence in 26% of the scans (odds ratio = 4.8). “With higher detection rates, PSMA should be the PET tracer of choice when PET-CT imaging is considered for subsequent treatment management decisions in patients with prostate cancer and biochemical recurrence after radical prostatectomy,” according to the investigators. Further research is needed to determine whether high detection rates translate into improved oncologic outcomes, they noted.
Disclosure: The study authors’ disclosure information may be found at thelancet.com.