Added Value of [18F]PSMA-1007 PET/CT and PET/MRI in Patients With Biochemically Recurrent Prostate Cancer: Impact on...

Area of Science:

• Radiology
• Nuclear Medicine
• Oncology

Background:

• Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is crucial for managing biochemically recurrent prostate cancer (BCR).
• PSMA PET imaging can alter treatment decisions in a significant portion of BCR patients.

Purpose of the Study:

• To evaluate the added diagnostic value of PET to MRI and CT in patients with BCR.
• To compare the impact of PET/MRI versus PET/CT on detection rates and clinical management.

Main Methods:

• Retrospective analysis of 41 patients with BCR undergoing 3T MRI, [18F]PSMA-1007 PET, and low-dose CT.
• Image interpretation by dual-reader teams (radiologist and nuclear medicine physician) using Likert scales.
• Assessment of interreader agreement and impact on intended treatment plans.

Main Results:

• PET/CT and PET/MRI demonstrated significantly higher detection rates compared to MRI/CT alone (22 and 18 patients vs. 7 patients, respectively).
• Interreader agreement improved from poor (κ=0.36) with MRI/CT to almost perfect (κ=0.85) with the addition of PET.
• Intended treatment plans were changed in 20 patients with PET/CT and 18 patients with PET/MRI.

Conclusions:

• The integration of [18F]PSMA-1007 PET with MRI and CT enhances detection rates for BCR.
• Adding PET imaging reduces interreader variability and impacts clinical management in approximately half of patients.
• Both PET/MRI and PET/CT offer significant benefits in the diagnostic workup of BCR.