Better Prostate Screening: proPSMA

Dr. Weeks’ Comment: Technology has advanced and now there is SUPERIOR prostate assessment and screening calledprostate-specific membrane antigen (PSMA) PET-CT.

Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multi-centre. “Sensitivity and specificity were also superior with PSMA PET-CT (sensitivity 85% vs. 38%, specificity 98% vs. 91%, respective”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30314-7/fulltext

AUTHOR  Michael S. Hofman.

Background…  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.

Findings…   We found high reporter agreement for PSMA PET-CT (κ=0·87 for nodal and κ=0·88 for distant metastases). In patients who underwent second-line image, management change occurred in seven (5%) of 136 patients following conventional imaging, and in 39 (27%) of 146 following PSMA PET-CT.

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

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