Detection of MRI-Invisible Disease Using PSMA PET/CT in a Patient Considering Focal Therapy

Area of Science:

• Oncology
• Radiology
• Urology

Background:

• Focal therapy (FT) for prostate cancer offers a less invasive treatment option.
• Accurate patient selection is paramount for successful FT outcomes.
• Current guidelines lack clear recommendations for PSMA PET/CT in FT planning.

Observation:

• A patient was identified as an ideal candidate for FT based on conventional MRI and biopsy.
• PSMA PET/CT imaging revealed a previously undetected contralateral lesion harboring cancer.
• This finding altered the initial assessment for FT eligibility.

Findings:

• PSMA PET/CT identified a clinically significant, contralateral prostate cancer lesion missed by standard imaging and biopsy.
• The utility of PSMA PET/CT in refining patient selection for focal therapy was demonstrated.

Implications:

• PSMA PET/CT may significantly improve the accuracy of patient selection for focal therapy.
• Integrating PSMA PET/CT into the FT planning pathway could prevent undertreatment or inappropriate treatment.
• Further research is warranted to establish definitive guidelines for PSMA PET/CT in focal therapy protocols.