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Updated: Jun 13, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Imaging Modality and Outcomes of Metastasis-Directed Therapy in Oligometastatic Castration-Resistant Prostate Cancer:
Matteo Bauckneht1,2, Liliana Belgioia3,2, Domenico Albano4,5
1IRCCS Azienda Ospedaliera Metropolitana, Genoa, Italy; matteo.bauckneht@unige.it.
Abstract:
It is unclear whether the imaging modality used to guide metastasis-directed therapy (MDT) influences outcomes in oligometastatic castration-resistant prostate cancer (omCRPC). Methods: We performed an updated analysis of the PRECISE-MDT cohort, adding 27 patients to the original cohort. MDT guided by prostate-specific membrane antigen (PSMA) PET/CT, choline PET/CT, and conventional imaging was compared in 102 patients with omCRPC. The primary outcomes were biochemical recurrence-free survival and overall survival after adjustment for inverse probability of treatment weighting. Results: MDT was guided by conventional imaging in 20 (19.6%) patients, choline PET/CT in 56 (54.9%) patients, and PSMA PET/CT in 26 (25.5%) patients. PSMA PET/CT guidance yielded longer biochemical recurrence-free survival than did choline PET/CT (median not reached [NR] vs. 11.7 mo, P = 0.031) and conventional imaging (NR vs. 7.1 mo, P = 0.002). Overall survival favored PSMA PET/CT versus conventional imaging (NR vs. 46.0 mo, P = 0.036). Conclusion: PSMA PET/CT guidance was associated with improved clinical outcome, supporting its therapeutic relevance for MDT planning in omCRPC.
Insights
Prostate cancer imaging guidance matters. Prostate-specific membrane antigen PET/CT (PSMA PET/CT) improved outcomes for metastasis-directed therapy (MDT) in oligometastatic castration-resistant prostate cancer (omCRPC) compared to other methods.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- Oligometastatic castration-resistant prostate cancer (omCRPC) is a challenging clinical scenario.
- The optimal imaging modality to guide metastasis-directed therapy (MDT) in omCRPC remains unclear.
- Previous studies suggest potential differences in outcomes based on imaging guidance.
Purpose of the Study:
- To compare the impact of different imaging modalities on patient outcomes in omCRPC undergoing MDT.
- To evaluate biochemical recurrence-free survival (BRFS) and overall survival (OS) based on imaging guidance.
Main Methods:
- An updated analysis of the PRECISE-MDT cohort included 102 patients with omCRPC.
- MDT was guided by prostate-specific membrane antigen PET/CT (PSMA PET/CT), choline PET/CT, or conventional imaging.
- Outcomes were analyzed using inverse probability of treatment weighting (IPTW) for adjustment.
Main Results:
- PSMA PET/CT guidance was associated with significantly longer BRFS compared to choline PET/CT (P=0.031) and conventional imaging (P=0.002).
- Overall survival was also significantly favored with PSMA PET/CT guidance versus conventional imaging (P=0.036).
- Conventional imaging guided MDT in 19.6%, choline PET/CT in 54.9%, and PSMA PET/CT in 25.5% of patients.
Conclusions:
- PSMA PET/CT guidance for MDT in omCRPC is associated with improved clinical outcomes.
- These findings support the therapeutic relevance of PSMA PET/CT for treatment planning in this patient population.
- Further research may confirm these benefits and refine treatment strategies.
