MRI confirmed as gold standard for pre-biopsy detection of prostate cancer—but that’s ‘not the end of the story’
A clinical trial pitting MRI against a burgeoning PET/CT technique has found the de facto defending champion better at revealing the presence of any grade of prostate cancer.
However, the PET/CT scans—which were enhanced with a radiotracer tuned to light up prostate-specific membrane antigen (PSMA) in cancer cells—were no worse than MRI at detecting cancers considered clinically significant.
The study’s authors, representing multiple centers in Australia and New Zealand, presented the work July 4 in Amsterdam at the annual congress of the European Association of Urology, according to a news release sent by the association.
Study leader Lih-Ming Wong, a professor and uro-oncologist at St. Vincent’s Hospital in Melbourne, and colleagues recruited 240 patients across five hospital groups who were at risk of prostate cancer.
Every patient’s prostate was scanned with both MRI and PSMA PET/CT. Patients’ respective urologists biopsied tissue identified on imaging as cancerous, which was the case for 75% of the patients (n = 181).
The urologists found clinically significant cancers in 82 of these 181 patients (45%).
They also found the MRI scans proved significantly more accurate than PSMA PET at detecting any grade of prostate cancer (0.75% for MRI vs 0.62% for PSMA PET).
Wong comments that the study “confirms that the existing ‘gold standard’ of pre-biopsy detection—the MRI—is indeed a high benchmark. Even with fine-tuning, we suspect PSMA PET/CT won’t replace MRI as the main method of prostate cancer detection.”
The news release also quotes Prof. Peter Albers of the European Association of Urology’s chief scientific office.
“New diagnostic tools need to be tested as carefully as new drugs, so we welcome the findings of this remarkable Phase III trial, which showed that MRI was superior in the detection of any prostate cancer,” Albers says.
Underscoring the non-inferiority of PSMA PET/CT for finding clinically significant cancers, Albers says:
[S]ince the ultimate goal of primary staging will be to detect only the more aggressive cancers and avoid unnecessary biopsy, this is not the end of the story. More research will be needed to explore the PSMA PET/CT correlation between the standard uptake value and cancer aggressiveness, but the first steps down the road in finding the best diagnostic approach to clinically significant prostate cancer have been taken.”
Full news release here (PDF).
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Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.