Advances in urology · 2026
18F-PSMA-1007 PET/CT Demonstrates Higher Accuracy for Biochemically Recurrent Prostate Cancer Compared to Contemporary Conventional Imaging.
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Stanton Zachary, Woloschuk Bonnie, Tamm Alexander, Hung Ryan, Trivedi Adwait, Kolinsky Michael, Usmani Nawaid, Rowe Lindsay, Moore Ronald, Wuest Frank, Abele Jonathan
Аннотация
PURPOSE: The goal of this study was to compare the accuracy of 18F-PSMA-1007 PET/CT to contemporary conventional imaging (contrast-enhanced CT scan of the chest, abdomen, and pelvis and a 99mTc-MDP whole body bone scan with SPECT/CT of the torso) in the setting of biochemically recurrent prostate cancer.
METHODS: This prospective nonrandomized Phase II cohort study clinical trial included 85 patients with biochemically recurrent prostate cancer (previous therapy). 18F-PSMA-1007 whole body PET/CT imaging was performed in all patients, with conventional imaging (contrast-enhanced CT scan of the chest, abdomen, and pelvis and a 99mTc-MDP whole body bone scan with SPECT/CT of the torso) then performed within 12 days. PROMISE criteria were used for PET/CT interpretation. After a minimum 1-year follow-up period, lesion-level and patient-level analyses were performed based on previously published reference criteria (Lawhn-Heath et al. 2019). The accuracy data were compared. Referring physicians were surveyed to help determine if the scans altered treatment. Categorical variables were compared using the McNemar test (p < 0.05 significant).
RESULTS: 53 patients with a total of 72 evaluable lesions were included in the analysis. 18F-PSMA-1007 PET/CT had a higher sensitivity than conventional imaging on a lesion level (100% compared with 58.3%) and higher overall accuracy on a patient level (90.6% compared with 62.3%, p < 0.05). The referring physicians felt that the 18F-PSMA-1007 PET/CT scans were beneficial to the clinical care of the patient in 90.6% of cases.
CONCLUSION: Overall, the findings support the use of 18F-PSMA-1007 over conventional imaging in the evaluation of patients with biochemically recurrent prostate cancer. Trial Registration: ClinicalTrials.gov.identifier: NCT04733768.
METHODS: This prospective nonrandomized Phase II cohort study clinical trial included 85 patients with biochemically recurrent prostate cancer (previous therapy). 18F-PSMA-1007 whole body PET/CT imaging was performed in all patients, with conventional imaging (contrast-enhanced CT scan of the chest, abdomen, and pelvis and a 99mTc-MDP whole body bone scan with SPECT/CT of the torso) then performed within 12 days. PROMISE criteria were used for PET/CT interpretation. After a minimum 1-year follow-up period, lesion-level and patient-level analyses were performed based on previously published reference criteria (Lawhn-Heath et al. 2019). The accuracy data were compared. Referring physicians were surveyed to help determine if the scans altered treatment. Categorical variables were compared using the McNemar test (p < 0.05 significant).
RESULTS: 53 patients with a total of 72 evaluable lesions were included in the analysis. 18F-PSMA-1007 PET/CT had a higher sensitivity than conventional imaging on a lesion level (100% compared with 58.3%) and higher overall accuracy on a patient level (90.6% compared with 62.3%, p < 0.05). The referring physicians felt that the 18F-PSMA-1007 PET/CT scans were beneficial to the clinical care of the patient in 90.6% of cases.
CONCLUSION: Overall, the findings support the use of 18F-PSMA-1007 over conventional imaging in the evaluation of patients with biochemically recurrent prostate cancer. Trial Registration: ClinicalTrials.gov.identifier: NCT04733768.