“PSMA-PET imaging gives us a more nuanced approach by giving us more accurate information,” says Jen-Jane Liu, MD.
Jen-Jane Liu, MD, associate professor, urology, Oregon Health & Science University, discusses the use of PSMA-PET imaging in patients with high-risk localized prostate cancer.
There are a couple of ways where I think PSMA really helps us, and the most common way is probably in patients who are high risk. So as more and more low-risk patients go on active surveillance, the pool of patients we're left with that we're treating that we believe have localized disease are higher risk. And because PSMA is more sensitive than conventional imaging, it may help you identify more metastatic disease.
Now we have to be cautious in how we utilize this information. If we use that information to change our decision making, that doesn't necessarily always portend a better outcome. So for example, if we find metastatic disease on a PSMA-PET and we elect not to treat that person because of that with local therapy, that may not actually be valid in terms of the data that we know have on patients in that scenario, because that data is based on conventional imaging. So we do have to be sort of thoughtful about how we utilize the information. But I think PSMA-PET does allow us to have a more nuanced approach, in that you may elect to choose a different treatment modality; or, if the patient is going to have radiation and you find additional sites of lymph node metastases, you may elect to expand your radiation field to include those and treat them if you can do so without causing a lot of toxicity. So I think what it does is it gives us a more nuanced approach by giving us more accurate information.
Transcript has been edited for clarity.