Adding PET scans to guided biopsies can improve prostate cancer detection

A new study published in the Journal of Nuclear Medicine asserts that a new method of prostate cancer imaging can make guided biopsies more precise and general understanding of the cancer clearer.

The new method tested was a combination of an F-18-choline positron emission tomography scan and multi-parametric prostate MRIs. The study found that the addition of PET scans allowed for more precisely targeted biopsies than just the multiparametric 3T MRIs (mpMRIs) alone. And it allows physicians to get a clearer view of which cancers might be clinically significant, even before the biopsies, researchers found.  

The study included 36 participants who were identified as having increasing prostate-specific antigen (PSA) levels. Of those 36 men initially scanned, 15 of them were found to have clinically significant cancer. A dozen of those cases were better identified using the targeted biopsies of this procedure than would be using standard biopsy procedures, which would have caught only five of those incidences of the clinically significant cancer.

Study author Morand Piert, MD, said this new ability to be extra accurate is especially important given the nature of prostate cancer, whose invasive cells can be spread out in more than one spot and which has a broad spectrum of severity levels.

"Since prostate cancer is often multi-focal and presents with multiple lesions of varying risk, it is important to identify the lesions that harbor the greatest malignant potential,” Piert said in a statement. “Accurate identification of clinically significant cancer and avoidance of clinically insignificant cancer is the centerpiece of modern prostate cancer diagnosis.”

Piert even speculated that someday such a method could be used to avoid biopsies altogether, with physicians able to learn everything they need to about a patient’s prostate cancer just through this (or similar) combined imaging programs.