68Ga-PSMA-HBED-CC PET/MRI Tops MRI for ID'ing Biochemical Recurrence

For men with biochemical recurrence of prostate cancer, ⁶⁸Ga-prostate-specific membrane antigen (PSMA)-HBED-CC positron emission tomography/magnetic resonance imaging (PSMA PET/MRI) has a higher detection rate compared with multiparametric MRI (mpMRI), according to a study recently published in Translational Oncology.

Juana Martinez, MD, from Weill Cornell Medicine in New York City, and colleagues compared the overall diagnostic performance of PSMA PET/MRI versus conventional mpMRI in patients with biochemically recurrent prostate cancer. From April 2018 to May 2021, 165 patients underwent PSMA PET/MRI, 108 of whom were presenting for biochemical recurrent disease.

When they evaluated patients with biochemical recurrence, the researchers found that PSMA PET/MRI had a higher detection rate than mpMRI. This pattern was seen for number of abnormal N1 lymph nodes, N2 lymph nodes, osseous, prostate/prostatic bed, and other lesions. The results were similar in a subanalysis performed using prostate-specific antigen levels, primary treatment modality, and time since androgen deprivation therapy. In a sensitivity analysis, for PSMA PET/MRI, sensitivity was 95.5 percent, positive predictive values were 87.5 percent, and the detection rate was 82.4 percent; for mpMRI, the corresponding values were 63.6, 84.9, and 54.9 percent.

“We conclude that PSMA PET/MRI is a robust imaging modality with higher sensitivity than multiparametric MRI alone for the detection of biochemical recurrence,” the authors write. “Together, this combined imaging modality is a powerful tool which can aid in not only the detection of the abnormal lesion, but also guide in treatment planning.”

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