Phase III Study of ¹⁸F-PSMA-1007 Versus ¹⁸F-Fluorocholine PET/CT for Localization of Prostate Cancer Biochemical...

Area of Science:

• Nuclear Medicine
• Oncology
• Radiopharmacology

Background:

• Prostate cancer (PCa) biochemical recurrence requires accurate localization for effective management.
• Current imaging modalities have limitations in detecting recurrent PCa, especially at low PSA levels.
• Novel PET tracers are being developed to improve diagnostic accuracy.

Purpose of the Study:

• To compare the diagnostic performance of 18F-PSMA-1007 PET/CT and 18F-fluorocholine PET/CT in localizing prostate cancer recurrence.
• To assess the impact of these imaging techniques on diagnostic thinking and therapeutic decision-making.

Main Methods:

• A prospective, randomized, crossover multicenter study involving 190 patients with suspected PCa recurrence.
• Patients underwent both 18F-PSMA-1007 PET/CT and 18F-fluorocholine PET/CT.
• Image interpretation by masked readers and a consensus panel for establishing a standard of truth.

Main Results:

• 18F-PSMA-1007 PET/CT demonstrated significantly higher correct detection rates (0.82) compared to 18F-fluorocholine PET/CT (0.65) (P < 0.0001).
• 18F-PSMA-1007 PET/CT more frequently influenced diagnostic thinking (93 vs. 56 patients) and led to adequate management changes (88 vs. 34 patients).
• The diagnostic information from 18F-PSMA-1007 PET/CT resulted in more beneficial patient management.

Conclusions:

• 18F-PSMA-1007 PET/CT is superior to 18F-fluorocholine PET/CT for localizing prostate cancer recurrence.
• Utilizing 18F-PSMA-1007 PET/CT results in improved diagnostic accuracy and more beneficial therapeutic decision-making for patients with recurrent PCa.