Mp25-11 Real-World Comparison of Utility of Psma Pet Imaging and Mri in Evaluation of Laterality of Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-11 REAL-WORLD COMPARISON OF UTILITY OF PSMA PET IMAGING AND MRI IN EVALUATION OF LATERALITY OF PROSTATE CANCER Jenna G. Winebaum, Janet E. Cowan, Kevin Chang, Hao G. Nguyen, and Peter R. Carroll Jenna G. WinebaumJenna G. Winebaum , Janet E. CowanJanet E. Cowan , Kevin ChangKevin Chang , Hao G. NguyenHao G. Nguyen , and Peter R. CarrollPeter R. Carroll View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As usage of PSMA PET imaging in prostate cancer expands beyond evaluation for recurrence, questions arise as to how it can be applied in the pre-treatment, localized patient. One of the primary challenges in the emerging world of focal therapy is proper patient selection, with MRI missing as much as 20% of clinically significant prostate cancers. We hoped to evaluate if PSMA could improve cancer localization and patient selection. We compared how well real-world reads of both MRI and PSMA PET predicted laterality on final prostatectomy specimen. METHODS: Patients with clinically localized prostate cancer, who had positive findings on MRI and PSMA PET imaging prior to radical prostatectomy (RP) at the University of California, San Francisco between 2015 and 2022. PSMA and MRI reports were reviewed for identification of focal lesion and laterality of the identified lesion. Primary outcome was match on laterality between dominant imaging lesions and RP specimen with a subset analysis by grade group (GG) on final pathology. RESULTS: 109 patients in our cohort had positive findings on PSMA imaging obtained pre-operatively and were included for analysis. 68/109 (62%) patients had high CAPRA clinical risk (6-10), and 71/109 (65%) had PRIADS 5 lesions on MRI. On final pathology 52/109 (48%) of patients had a high (6-10) surgical CAPRA-S score. 80/109 (73%) of PSMA scans exhibited an exact match with laterality of highest Gleason grade lesion on final pathology, regardless of grade (78% match among GG2, 67% match for GG3, 76% match for GG4-5, p=0.49). 52% of MRI exhibited an exact match on final pathology. CONCLUSIONS: In our initial review of PSMA's utility in predicting laterality shows it may perform at least as well, if not better than MRI. Further comparison with mapping to the gold standard, radical prostatectomy specimen is required. However, it is an interesting potential tool in the arsenal of the physician hoping to select patients for focal therapy and warrants further investigation. Source of Funding: Goldberg-Benioff Fund for Translational Cancer Biology © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e408 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jenna G. Winebaum More articles by this author Janet E. Cowan More articles by this author Kevin Chang More articles by this author Hao G. Nguyen More articles by this author Peter R. Carroll More articles by this author Expand All Advertisement PDF downloadLoading ...