2nd PET scan changes treatment for nearly half of prostate cancer patients
Undergoing a second PSMA (prostate-specific membrane antigen) PET scan changes treatment for nearly half of prostate cancer patients whose initial exam was negative, according to new research.
Managing recurrent prostate cancer after first-line treatment remains a key clinical challenge, experts write in The Journal of Nuclear Medicine. While PSMA PET has helped improved detection, 30% of patients still have zero discernible disease on initial imaging.
Canadian researchers recently aimed to better understand the impact of these follow-up scans, analyzing data from hundreds of patients who were re-imaged.
“There is little information on the utility of repeating a PSMA PET after an initial negative scan,” lead author Ur Metser, MD, a professor of radiology at the University of Toronto, said in a statement July 7. “In our study, my colleagues and I sought to determine the benefit of a second PSMA PET scan, as well as to assess predictors for positive PSMA PET scans.”
For the study, researchers used information from the PSMA PET Registry for Recurrent Prostate Cancer in Ontario, with patients recruited between 2018-2022. Out of over 4,000 participants, 210 met this study’s criteria, having received more than one PSMA PET scan, with the initial imaging coming up negative.
The second PET revealed evidence of disease in about 56% of recurrent prostate cancer patients. A care management change was necessary for nearly 50% of patients, particularly for those with oligometastatic disease. Repeat imaging was most likely to detect cancer in patients with higher prostate-specific antigen testing levels and a PSA doubling time of less than 12 months.
“The findings in this study further strengthen the pivotal role of PSMA PET in the management of men with recurrence of prostate cancer after first-line therapy,” Metser said in the announcement from the Society of Nuclear Medicine & Molecular Imaging, which publishes the journal. “Understanding the extent of disease in patients who have initial negative PSMA PET scans provides valuable information for physicians as they create treatment plans.”
Read more, including potential study limitations, in JNM.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.