18F-PSMA-1007 PET/CT Outperforms MRI in Prostate Cancer Staging

For men undergoing locoregional staging of prostate cancer, fluorine-18 prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (18F-PSMA-1007 PET/CT) has been found to be more effective than multiparametric magnetic resonance imaging (MRI). This finding was reported in a study published online on July 1 in JAMA Oncology, coinciding with the annual meeting of the Canadian Urological Association, held from June 29 to July 1 in Victoria.

Dr. Nikhile Mookerji from the University of Alberta in Edmonton, Canada, along with his colleagues, assessed the accuracy of 18F-PSMA-1007 PET/CT in comparison to multiparametric MRI in the primary locoregional staging of intermediate- and high-risk prostate cancers. This assessment was part of the Next Generation Trial, a phase 2 study. The study involved patients who underwent all necessary imaging studies and radical prostatectomies at two tertiary care hospitals. Out of 150 eligible men with prostate cancer, 134 underwent radical prostatectomy.

The research team discovered that 18F-PSMA-1007 PET/CT was significantly better than MRI in accurately identifying the final pathological tumor stage, with 45 percent accuracy for PET/CT compared to 28 percent for MRI. Additionally, 18F-PSMA-1007 PET/CT outperformed MRI in several other critical areas: it was superior in identifying the dominant nodule with 94 percent accuracy versus 83 percent for MRI, identifying laterality with 64 percent accuracy versus 44 percent for MRI, and detecting extracapsular extension with 75 percent accuracy versus 63 percent for MRI. However, it was not significantly superior to MRI in identifying seminal vesicle invasion.

The researchers suggest that future studies should focus on evaluating the accuracy of combining PET/CT and MRI, as well as the cost-effectiveness of using PET/CT for the primary staging of men with prostate cancer.